Adeyemo Wasiu L, Adeyemo Titilope A, Ogunlewe Mobolanle O, Desalu Ibironke, Ladeinde Akinola L, Mofikoya Bolaji O, Adeyemi Michael O, Akanmu Alani S
Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos, Nigeria.
Int J Pediatr Otorhinolaryngol. 2011 May;75(5):691-4. doi: 10.1016/j.ijporl.2011.02.015. Epub 2011 Mar 12.
Cleft lip surgery is a common procedure performed by surgeons worldwide. The aim of the study was to determine blood transfusion requirements and factors influencing blood transfusion in cleft lip surgery.
Transfusion rate in 100 consecutive patients who had cleft lip surgery was prospectively evaluated at the Lagos University Teaching Hospital, Nigeria. Data collected included age and sex of patients, type of cleft defects, type of surgery done, preoperative haematocrit, duration of surgery, amount of blood loss during surgery, the number of units of blood cross-matched and those used. Cardiovascular parameters at the point of transfusion were also recorded. Each patient was made to donate a unit of homologous blood prior to surgery.
Mean estimated blood loss during surgery was 26.5 ± 47.1 ml. Most patients (92%) lost between 2 and 50 ml of blood. Mean estimated blood loss in unilateral cleft lip surgery was not significantly differently from that of bilateral cleft lip surgery (P=0.46). Only five patients (5%) required blood transfusion. The mean blood transfused was 50.0 ± 16.9 ml. All the patients transfused had a preoperative haematocrit of <30% (23-27%). The cross-match-to-transfusion ratio for cleft surgery was 20. The transfusion index was 0.05 and overall blood-ordering quotient was 20.
Cleft lip surgery is a low volume blood loss surgery. Homologous blood donation prior to cleft lip surgery in patients with preoperative haematocrit of 30% or more is not necessary. For patients with preoperative haematocrit of less than 30%, type and screen of donated blood should be adequate.
唇裂手术是全球外科医生都常开展的一种手术。本研究旨在确定唇裂手术中的输血需求以及影响输血的因素。
在尼日利亚拉各斯大学教学医院，对连续100例行唇裂手术的患者的输血率进行前瞻性评估。收集的数据包括患者的年龄和性别、唇裂缺损类型、所做的手术类型、术前血细胞比容、手术时长、手术中的失血量、交叉配血的单位数以及实际使用的单位数。还记录了输血时的心血管参数。每位患者在手术前捐献一个单位的同源血。
手术中的平均估计失血量为26.5±47.1毫升。大多数患者（92%）失血量在2至50毫升之间。单侧唇裂手术的平均估计失血量与双侧唇裂手术相比无显著差异（P=0.46）。仅5名患者（5%）需要输血。平均输血量为50.0±16.9毫升。所有接受输血的患者术前血细胞比容均<30%（23 - 27%）。唇裂手术的交叉配血与输血比例为20。输血指数为0.05，总体用血预定系数为20。
唇裂手术是一种失血量少的手术。术前血细胞比容为30%或更高的患者在唇裂手术前无需进行同源血捐献。对于术前血细胞比容低于30%的患者，所捐献血液的血型鉴定和筛查应足够。
