Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology; School of Dentistry, The University of Jordan; Amman, 11942 Jordan.
Department of Prosthodontics, School of Dentistry, The University of Jordan, Amman, 11942 Jordan.
J Stomatol Oral Maxillofac Surg. 2019 Nov;120(5):443-449. doi: 10.1016/j.jormas.2018.12.013. Epub 2019 Jan 1.
In the absence of infection-specific clinical signs and symptoms, it is often difficult for the maxillofacial surgeon to decide whether leukocytosis after orthognathic surgery is part of the normal postoperative response, as suggested for a variety of non-maxillofacial surgeries, or a sign of a developing infection. The aim was to determine the trends and factors predictive of postoperative WBC (white blood cell) values after orthognathic surgery that may provide the surgeon appropriate guidance for decision making.
This retrospective cohort study included a total of 83 consecutive patients who underwent 93 orthognathic surgical cases over six years. The natural history of postoperative WBC values and incidence of leukocytosis were characterized, and their differences across potential predictor variables were then analyzed using univariate analysis and multivariate regression analysis.
On post-operative day (POD) 1, the mean post-operative WBC count reached the peak level, with an increase of 11.4 × 10 cells/μL. By POD 2, it declined slightly to a level approximately two times more than the preoperative level. Over the first two post-operative days, the incidence of leukocytosis was 93.5%. Multivariate regression analyses revealed that gender, duration of surgery and pre-operative WBC count were the only significant predictors of the post-operative WBC value, whereas the pre-operative WBC count was the only significant (OR: 2.61, P < 0.05) predictor of post-operative leukocytosis.
Post-operative leukocytosis after orthognathic surgery is significantly influenced by the pre-operative WBC count, and has similar trends with a much higher incidence, compared to non-maxillofacial surgeries.
在缺乏感染特异性临床体征和症状的情况下，颌面外科医生通常难以确定正颌手术后的白细胞增多是否属于正常术后反应，就像各种非颌面手术所建议的那样，或者是否是感染发展的迹象。目的是确定正颌手术后白细胞计数（WBC）的变化趋势和预测因素，以便为外科医生提供适当的决策指导。
这项回顾性队列研究共纳入了 83 例连续患者，他们在六年期间共进行了 93 例正颌手术。对术后 WBC 值的自然变化过程和白细胞增多的发生率进行了特征描述，然后使用单变量分析和多变量回归分析对潜在预测变量进行了分析。
术后第 1 天（POD1），平均术后 WBC 计数达到峰值，增加了 11.4×10 个/μL。到 POD2，略有下降至约术前水平的两倍。在头两天的术后期间，白细胞增多的发生率为 93.5%。多变量回归分析显示，性别、手术时间和术前 WBC 计数是术后 WBC 值的唯一显著预测因素，而术前 WBC 计数是术后白细胞增多的唯一显著（OR：2.61，P<0.05）预测因素。
与非颌面手术相比，正颌手术后的白细胞增多受术前 WBC 计数的显著影响，且具有相似的变化趋势，但发生率要高得多。
