Rohling R G, Zimmermann A P, Biro P, Haers P E, Sailer H F
Department of Craniomaxillofacial Surgery, University Hospital Zurich, Switzerland.
Int J Adult Orthodon Orthognath Surg. 1999;14(1):77-82.
Bimaxillary orthognathic surgery and genioplasty are frequently performed to correct dentoskeletal anomalies in otherwise healthy young patients. Until 1990 homologous blood transfusions were routinely necessary for these procedures. The present study describes a protocol of blood-saving measures that was adopted and tested on a continuous sample of 127 patients treated between 1994 and 1997. The protocol comprises acute normovolemic hemodilution, controlled moderate hypotension, positioning the surgical field above the heart level, cell saving, intraoperative homeostasis, preoperative autologous blood donation, administration of recombinant erythropoietin, and acceptance of a low hematocrit perioperatively. This study shows that homologous blood transfusions may be avoided intraoperatively by following the protocol described.
双颌正颌手术和颏成形术常用于矫正健康年轻患者的牙颌面畸形。直到1990年，这些手术常规需要输入同种异体血。本研究描述了一种血液保护措施方案，该方案在1994年至1997年间连续纳入的127例患者中采用并进行了测试。该方案包括急性等容性血液稀释、控制性适度低血压、将手术区域置于心脏水平以上、细胞回收、术中维持内环境稳定、术前自体血捐献、给予重组促红细胞生成素以及接受围手术期低血细胞比容。本研究表明，遵循所述方案可在术中避免输入同种异体血。
