Henderson N J, Crawford P J, Bell C N
Division of Child Dental Health, Bristol Dental Hospital, UK.
J R Coll Surg Edinb. 1997 Oct;42(5):349-52.
The potential for significant blood loss following deciduous tooth extractions has been a factor in treatment planning in dental care for children. This paper reports the results of a study which aimed to quantify normal blood loss following extraction of deciduous teeth from medically fit children under general anaesthetic. Blood loss from a group of 50 children aged 3 to 5 years, having at least one molar tooth removed, was determined by comparing the amount of haemoglobin in a sample of the patient's whole blood with a known dilution of blood collected during surgery and recovery. Total blood loss ranged from 2.5 to 57 mL, with the maximum corresponding to deciduous clearance of (the removal of all deciduous teeth from) the upper arch together with the lower molars for a 3-year-old child. Clinical judgement would suggest that the maximum potential blood loss resulting from a complete dental clearance (20 teeth) from an otherwise fit child in this age group is unlikely to be greater than 100 mL. It is concluded that the risk of inducing hypovolaemic shock from this procedure is much lower than the risks of using repeated administrations of general anaesthesia to facilitate a staged dental clearance.
乳牙拔除后出现大量失血的可能性一直是儿童牙科护理治疗计划中的一个考量因素。本文报告了一项研究结果，该研究旨在量化在全身麻醉下从健康儿童拔除乳牙后的正常失血量。通过将患者全血样本中的血红蛋白量与手术和恢复期间收集的已知稀释血液进行比较，确定了一组50名年龄在3至5岁、至少拔除一颗磨牙的儿童的失血量。总失血量在2.5至57毫升之间，其中最大值对应于一名3岁儿童上颌（拔除所有乳牙）以及下颌磨牙的乳牙清除。临床判断表明，这个年龄组中原本健康的儿童进行完全牙齿清除（20颗牙齿）导致的最大潜在失血量不太可能超过100毫升。结论是，该手术引发低血容量性休克的风险远低于使用重复全身麻醉来促进分阶段牙齿清除的风险。
