Reich Waldemar, Kriwalsky Marcus S, Wolf Hans H, Schubert Johannes
Oral and Maxillofacial Plastic Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
Oral Maxillofac Surg. 2009 Jun;13(2):73-7. doi: 10.1007/s10006-009-0154-8.
PURPOSE AND RESULTS: The aim of this prospective study was to determine the incidence of postoperative bleeding after oral surgery under local anaesthesia performed in outpatients with haemostatic disorders within a 5-year period (2003-2007). One hundred twenty one (70 males, 51 females) out of 2,056 outpatients with different haemostatic disorders (acquired or hereditary) were included in this study. The following data were recorded: medical history and general condition; medications; indication for the surgical procedure; specification of local anaesthesia; applied surgical techniques, considering the kind of haemostatic disorder; and peri- or postoperative bleeding complications. Postoperative bleeding was observed in 12 patients (9.9%). In three cases, inpatient treatment became necessary. The management of two patients with a haemostatic disorder (von Willebrand s disease and haemophilia A) is presented in short case reports.
In a heterogeneous group of 121 outpatients with known haemostatic disorders, a combination of a few haemostatic agents with appropriate operative technique enables an effective wound management. In cases of failed local interventions after postoperative bleeding, further diagnostic investigations are required.
目的与结果:本前瞻性研究旨在确定2003年至2007年5年间,在门诊对有止血障碍的患者进行局部麻醉下口腔手术后出血的发生率。本研究纳入了2056例患有不同止血障碍(获得性或遗传性)的门诊患者中的121例(70例男性,51例女性)。记录了以下数据:病史和一般状况;用药情况;手术指征;局部麻醉的具体情况;应用的手术技术,考虑止血障碍的类型;以及围手术期或术后出血并发症。12例患者(9.9%)出现术后出血。3例患者需要住院治疗。简短病例报告介绍了2例有止血障碍(血管性血友病和甲型血友病)患者的治疗情况。
在121例已知有止血障碍的门诊患者这一异质性群体中,几种止血剂与适当的手术技术相结合能够实现有效的伤口处理。术后出血经局部干预失败的病例,需要进一步的诊断性检查。