Eaton A C, Marsh J L, Pilgram T K
Department of Surgery, Washington University School of Medicine, St. Louis, Mo.
Plast Reconstr Surg. 1995 Feb;95(2):277-83. doi: 10.1097/00006534-199502000-00007.
Retrospective review of the records of 73 consecutive young children who underwent craniosynostosis surgery between 1978 and 1992 in one center was conducted to determine transfusion requirements, to document morbidity, and to identify causative variables associated with transfusion. Operative age and weight, affected suture(s), craniofacial surgeon, neurosurgeon, anesthesiologist, preoperative and postoperative hematocrit, and transfusion volumes of blood and crystalline products were recoded. Transfusion volumes were converted to percent estimated red cell mass for analysis. Affected sutures were unicoronal (22), sagittal (17), bicoronal (11), multiple (11), metopic (10), and lambdoid (2). Mean operative age was 6.4 months. Mean preoperative hematocrit was 34 percent. Eighty percent of patients were discharged with hematocrit of 29 percent or greater. Discharge hematocrit was unrelated to year of surgery. Mean intraoperative transfusion was 72.1 +/- 56.6 percent estimated red cell mass. Transfusions differed statistically among suture(s), neurosurgeons, and anesthesiologists. Extensive cranio-orbital surgery for synostosis in young children does not produce excessive hemorrhage or transfusion morbidity. The anesthesiologist and neurosurgeon may be equally or more important than the affected suture(s) as causal variables in transfusion.
对1978年至1992年间在一个中心接受颅缝早闭手术的73例连续幼儿的记录进行回顾性研究，以确定输血需求、记录发病率，并确定与输血相关的致病变量。记录手术年龄和体重、受累缝线、颅面外科医生、神经外科医生、麻醉医生、术前和术后血细胞比容以及血液和晶体产品的输血量。将输血量转换为估计红细胞量的百分比进行分析。受累缝线为单冠状缝（22例）、矢状缝（17例）、双冠状缝（11例）、多条缝（11例）、额缝（10例）和人字缝（2例）。平均手术年龄为6.4个月。术前平均血细胞比容为34%。80%的患者出院时血细胞比容为29%或更高。出院时的血细胞比容与手术年份无关。术中平均输血量为估计红细胞量的72.1±56.6%。不同缝线、神经外科医生和麻醉医生之间的输血情况在统计学上存在差异。幼儿广泛的颅眶缝早闭手术不会导致过多出血或输血相关并发症。作为输血的致病变量，麻醉医生和神经外科医生可能与受累缝线同样重要或更重要。
