White Nicholas, Marcus Ritchie, Dover Stephen, Solanki Guirish, Nishikawa Hiroshi, Millar Carol, Carver Edmund D
Department of Anaesthesia, Birmingham Children's Hospital, Birmingham, United Kingdom.
J Craniofac Surg. 2009 Mar;20(2):378-81. doi: 10.1097/SCS.0b013e31819b9429.
Fronto-orbital advancement and remodeling for craniosynostosis is extensive surgery and is associated with potential risks; the most significant of these is blood loss. We prospectively studied 116 consecutive patients undergoing fronto-orbital advancement by the same surgical team for a 5-year 6-month period to determine what factors are associated with blood loss and transfusion of blood products. The data collected on the calvarial sutures involved were whether the patient had a diagnosed syndrome, the age at operation, the length of the operation, the estimated blood volume lost during the perioperative course, the number of units of packed cells transfused (donor exposures), and the use of other blood products. The mean (SD) total blood volume lost was 116% (5.4) of the estimated preoperative volume. The median number of whole units of packed cells transfused was 2 units. Other blood products were given in 28% of the cases. There was significantly greater blood loss in those patients with recognized craniofacial syndromes, pansynostosis, an operating time longer than 5 hours, and an age of 18 months or younger at operation. The use of other blood products was associated with those patients losing a blood volume higher than the mean.
额眶前移术治疗颅缝早闭是一项大型手术，且存在潜在风险；其中最严重的是失血。我们对同一手术团队在5年6个月期间连续进行额眶前移术的116例患者进行了前瞻性研究，以确定哪些因素与失血及血液制品输注相关。收集的关于所涉及颅骨缝线的数据包括患者是否患有已确诊的综合征、手术年龄、手术时长、围手术期估计失血量、输注的浓缩红细胞单位数（供血者暴露情况）以及其他血液制品的使用情况。平均（标准差）总失血量为术前估计血量的116%（5.4）。输注的浓缩红细胞全单位数中位数为2个单位。28%的病例使用了其他血液制品。患有公认的颅面综合征、全颅缝早闭、手术时间超过5小时以及手术年龄在18个月及以下的患者失血明显更多。使用其他血液制品与失血量高于平均水平的患者相关。
