Department of Oral and Maxillofacial Surgery, Istanbul Medipol University, Faculty of Dentistry, Atatürk Bulvarı No: 27 Fatih, 34083 Istanbul, Turkey.
Department of Oral and Maxillofacial Surgery, Istanbul Medipol University, Faculty of Dentistry, Atatürk Bulvarı No: 27 Fatih, 34083 Istanbul, Turkey.
J Stomatol Oral Maxillofac Surg. 2021 Feb;122(1):29-32. doi: 10.1016/j.jormas.2020.05.002. Epub 2020 May 13.
Postoperative bleeding after orthognathic surgery is a rare but life-threatening complication. Maxillary surgery is the main cause of bleeding, after which excessive epistaxis can occur until the 10th postoperative day. Due to the risk of secondary bleeding, the patient discharge process may be complicated for both the patient and clinician. Thus far, no studies have explored massive intra- and postoperative bleeding in patients undergoing orthognathic surgery. Therefore, this study was performed to determine the prevalence of postoperative secondary bleeding and its correlation with intraoperative massive bleeding in patients undergoing orthognathic surgery.
A total of 206 orthognathic surgery patients were included in this retrospective study. Perioperative data was collected by determining the number of patients who referred to the clinic for treatment of secondary bleeding. The following parameters were recorded: occurrence of intraoperative massive bleeding, pre- and postoperative haemoglobin and haematocrit values, intraoperative projected bleeding, amount of intravenous liquid needed, and length of hospital stay. In addition, the association between secondary and intraoperative massive bleeding was investigated.
Two of 206 patients (0.97%) experienced both massive intraoperative bleeding and massive postoperative bleeding.
Intra- and postoperative massive bleeding occurred only in a small number of patients; thus, longer hospitalisation and strict follow-up of this small group of patients may be required.
正颌手术后出血是一种罕见但危及生命的并发症。上颌手术是出血的主要原因，术后 10 天内可能会发生大量鼻出血。由于存在继发性出血的风险，患者和临床医生的出院过程可能会变得复杂。到目前为止，还没有研究探讨正颌手术患者的大量术中及术后出血情况。因此，本研究旨在确定接受正颌手术患者术后继发性出血的发生率及其与术中大量出血的相关性。
本回顾性研究共纳入 206 例正颌手术患者。通过确定因继发性出血就诊的患者数量来收集围手术期数据。记录以下参数：术中大量出血的发生情况、术前和术后血红蛋白和血细胞比容值、术中预计出血量、静脉输液量和住院时间。此外，还研究了继发性和术中大量出血之间的关系。
206 例患者中有 2 例（0.97%）同时发生术中大量出血和术后大量出血。
仅少数患者发生术中及术后大量出血；因此，可能需要对这一小部分患者进行更长时间的住院治疗和严格的随访。
