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正颌手术中失血的预测因素:一所教学机构的研究结果

Predictors of blood loss during orthognathic surgery: outcomes from a teaching institution.

作者信息

Schneider Keith M, Altay Mehmet Ali, Demko Catherine, Atencio Isabel, Baur Dale A, Quereshy Faisal A

机构信息

School of Dental Medicine, Department of Oral and Maxillofacial Surgery, Case Western Reserve University, Cleveland, OH, USA.

Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Akdeniz University, Dumlupinar Boulevard 07058 Campus, Antalya, Turkey.

出版信息

Oral Maxillofac Surg. 2015 Dec;19(4):361-7. doi: 10.1007/s10006-015-0503-8. Epub 2015 May 3.

Abstract

PURPOSE

The objective of the study was to correlate different orthognathic surgical procedures with operating time and blood loss, reported from an accredited resident training institution.

METHODS

Ninety-five patient records were evaluated retrospectively. Individual blood volume, percent blood volume lost (BVL), and estimated blood loss (EBL) for each patient were recorded and correlated with operating time (OT). Statistics included independent t tests, one-way analysis of variance, and linear regression.

RESULTS

The mean OT for all procedures was 203 min with mean blood loss 556 ml. Mean EBL for males was 676 ml versus 468 ml for females. Overall BVL was 12.4 %, while for males, BVL was 13.3 % compared to 11.8 % for females. For a single orthognathic procedure (n = 45), mean OT 145 min., EBL 414 ml, and BVL 9.0 %; two procedures (n = 41), mean OT was 239 min., EBL 659 ml, and BVL 15 %; three procedures (n = 9), mean OT 328 min, EBL 793 ml, and BVL was 17 %.

CONCLUSION

Examination of individual procedures suggests a shorter OT for Le Fort I procedures with slightly greater EBL. Concomitant orthognathic procedures are associated with greater OT and EBL. Blood volume should be calculated for male and female patients separately. Percent BVL can be predicted based on OT using a basic equation.

摘要

目的

本研究的目的是将不同的正颌外科手术与手术时间和失血量相关联,这些数据来自一家经认可的住院医师培训机构。

方法

对95份患者记录进行回顾性评估。记录每位患者的个体血容量、失血量百分比(BVL)和估计失血量(EBL),并将其与手术时间(OT)相关联。统计方法包括独立t检验、单因素方差分析和线性回归。

结果

所有手术的平均手术时间为203分钟,平均失血量为556毫升。男性的平均估计失血量为676毫升,女性为468毫升左右。总体失血量百分比为12.4%,男性为13.3%,女性为11.8%。对于单一正颌手术(n = 45),平均手术时间145分钟,估计失血量414毫升,失血量百分比9.0%;两项手术(n = 41),平均手术时间为239分钟,估计失血量659毫升,失血量百分比15%;三项手术(n = 9),平均手术时间328分钟,估计失血量793毫升,失血量百分比为17%。

结论

对个体手术的检查表明,Le Fort I型手术的手术时间较短,但估计失血量略多。同期进行正颌手术与更长的手术时间和更多的估计失血量相关。应分别计算男性和女性患者的血容量。可以使用一个基本方程根据手术时间预测失血量百分比。

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