Samman N, Cheung L K, Tong A C, Tideman H
Department of Oral and Maxillofacial Surgery, University of Hong Kong, Hong Kong.
J Oral Maxillofac Surg. 1996 Jan;54(1):21-4; discussion 25-6. doi: 10.1016/s0278-2391(96)90295-5.
This study quantified the blood loss and transfusion requirements in orthognathic surgery.
Three hundred sixty consecutive healthy orthognathic surgery patients were included in this retrospective study. The female:male ratio was 1.8:1, and the age range was 8 to 49 years (mean, 24). Estimated blood volume (EBV), estimated blood loss (EBL), and transfused blood were calculated.
EBL ranged from 50 to 5,000 mL (mean, 600) representing up to 73% of EBV (mean, 16%). In total, 24% (84 patients) were transfused, 8.7% (6 patients) after single-jaw surgery and iliac bone harvest and 26.7% (78 patients) after bimaxillary osteotomies. Forty-seven patients received 1 unit of transfused blood, 25 patients had 2 units, and 12 patients had more than 2 units. Most transfused patients lost 11% to 40% of EBV.
Transfusion is not necessary for single-jaw surgery unless a bicoronal flap or iliac bone harvest are required. Although only 27% of bimaxillary osteotomy patients required transfusion of 1 to 2 units, this group was not predictable based on the type of procedure involved, and a further subgroup (4% of the 291 patients) required a larger transfusion.
本研究对正颌外科手术中的失血量和输血需求进行量化。
本回顾性研究纳入了连续360例健康的正颌外科手术患者。男女比例为1.8:1，年龄范围为8至49岁（平均24岁）。计算估计血容量（EBV）、估计失血量（EBL）和输血量。
EBL范围为50至5000 mL（平均600 mL），占EBV的比例高达73%（平均16%）。总计24%（84例患者）接受了输血，单颌手术加髂骨取骨术后有8.7%（6例患者）输血，双颌截骨术后有26.7%（78例患者）输血。47例患者接受了1单位输血量，25例患者接受了2单位输血量，12例患者接受了超过2单位的输血量。大多数接受输血的患者失血量占EBV的11%至40%。
单颌手术除非需要双侧冠状瓣或髂骨取骨，否则无需输血。虽然双颌截骨术患者中只有27%需要输注1至2单位血液，但基于所涉及的手术类型，该组患者无法预测，并且有一个进一步的亚组（291例患者中的4%）需要大量输血。
