Johansson Krister, Lindström Martin, Alhabshi Manaf, Ahmad Marianne, Svensson Peter J, Becktor Jonas P
Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, MalmöSweden.
Department of Oral & Maxillofacial Surgery, Skåne University Hospital, LundSweden.
J Oral Maxillofac Res. 2021 Jun 30;12(2):e3. doi: 10.5037/jomr.2021.12203. eCollection 2021 Apr-Jun.
Estimating blood loss is an important factor in several surgical procedures. The accuracy of blood loss measurements in situations where blood is mixed with saliva and saline is however uncertain. The purpose of this laboratory study was to ascertain if blood loss measurements in mixtures of blood, saline, and saliva are reliable and could be applicable in a clinical setting.
Venous blood and resting saliva were collected from six volunteers. Saliva, saline, and combinations thereof were mixed with blood to obtain different concentrations. A portable spectrophotometer was first used to measure the haemoglobin concentration in undiluted venous blood followed by measurements of the haemoglobin concentration after each dilution. To examine the strength of linear relationships, linear regression and Pearson correlations were used.
The measurements of haemoglobin concentrations in mixtures of blood, saline, and saliva were proven to be accurate for haemoglobin measurements > 0.3 g/dl (correlation = 0.986 to 1). For haemoglobin measurements < 0.3 g/dl, a small increase in haemoglobin values were reported, which was directly associated to the saliva concentration in the solution (correlation = 0.983 to 1). This interference of saliva was significantly eliminated by diluting the samples with saline, mimicking the clinical situation.
The results suggest that a portable spectrophotometer can be used clinically to preoperatively measure the haemoglobin value of a venous blood sample and postoperatively measure the haemoglobin value of the collected liquids, including shed blood, thereby achieving a highly accurate method of measuring blood loss during oral and maxillofacial surgery.
估计失血量是多种外科手术中的一个重要因素。然而，在血液与唾液和盐水混合的情况下，失血量测量的准确性尚不确定。本实验室研究的目的是确定血液、盐水和唾液混合物中的失血量测量是否可靠，以及是否可应用于临床环境。
从六名志愿者身上采集静脉血和静息唾液。将唾液、盐水及其组合与血液混合以获得不同浓度。首先使用便携式分光光度计测量未稀释静脉血中的血红蛋白浓度，然后在每次稀释后测量血红蛋白浓度。为了检验线性关系的强度，使用了线性回归和皮尔逊相关性分析。
对于血红蛋白测量值>0.3 g/dl，血液、盐水和唾液混合物中血红蛋白浓度的测量被证明是准确的（相关性=0.986至1）。对于血红蛋白测量值<0.3 g/dl，报告血红蛋白值有小幅增加，这与溶液中的唾液浓度直接相关（相关性=0.983至1）。通过用盐水稀释样品模拟临床情况，唾液的这种干扰被显著消除。
结果表明，便携式分光光度计可在临床上用于术前测量静脉血样本的血红蛋白值，并在术后测量所收集液体（包括失血）的血红蛋白值，从而实现一种在口腔颌面外科手术中测量失血量的高度准确的方法。
