Operative time, blood loss, hemoglobin drop, blood transfusion, and hospital stay in orthognathic surgery
Operative time, blood loss, hemoglobin drop, blood transfusion, and hospital stay in orthognathic surgery
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DOI：
10.1007/s10006-017-0626-1
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发表时间：
2017-06-01
影响因子：
1.8
通讯作者：
Al-Qarzaee, Mohammed Abdullah
中科院分区：
文献类型：
--
作者：
Salma, Ra'ed Ghaleb;Al-Shammari, Fahad Mohammed;Al-Qarzaee, Mohammed Abdullah
目的评价正颌手术的手术时间、出血量、血红蛋白下降、输血量及住院时间。方法回顾性分析10年的双侧矢状面劈开截骨术（带或不带颏成形术）、Le Fort I型截骨术（带或不带颏成形术）或任何联合手术的患者。共纳入271例患者。结果患者年龄17 ~ 49岁，平均年龄24.13±4.51岁。大约62%的患者接受了双颌手术。最常见的手术是双侧矢状面切开Le Fort I（37%）。平均手术时间3.96 +/- 1.25 h，平均估计失血量345.2 +/- 149.74 mL，约9%患者接受术中输血。非输血组平均血红蛋白下降2.38±0.89 g/dL。术后平均住院时间为1.85±0.83天。只有一名患者在重症监护室住了一晚。结论在正颌手术中，出血量相对较少，输血频繁，不可能住院。手术时间、出血量、输血和手术过程的复杂性会显著增加住院时间。在正颌手术中，男性可能比女性出血更多。在正颌手术中，由于血液稀释，血红蛋白下降可能会被高估，这可能会影响输血的决定。
Purpose This study was conducted to evaluate the operative time, blood loss, hemoglobin drop, blood transfusion, and length of hospital stay in orthognathic surgery.Methods A 10-year retrospective analysis was performed on patients who underwent bilateral sagittal split osteotomy (with or without genioplasty), Le Fort I osteotomy (with or without genioplasty), or any combination of these procedures. A total of 271 patients were included.Results The age range was 17 to 49 years, with a mean age of 24.13 +/- 4.51 years. Approximately 62% of patients underwent double-jaw surgery. The most common procedure was bilateral sagittal split with Le Fort I (37%). The average operative time was 3.96 +/- 1.25 h. The mean estimated blood loss was 345.2 +/- 149.74 mL. Approximately 9% of patients received intraoperative blood transfusion. The mean hemoglobin drop in the non-transfusion cases was 2.38 +/- 0.89 g/dL. The mean postoperative hospital stay was 1.85 +/- 0.83 days. Only one patient was admitted to the ICU for one night.Conclusions In orthognathic surgery, blood loss is relatively minor, blood transfusion is frequent, and ICU admission is unlikely. Operative time, blood loss, blood transfusion, and the complexity of the surgical procedure can significantly increase the length of hospital stay. Males may bleed more than females in orthognathic surgery. Hemoglobin drop can be overestimated due to hemodilution in orthognathic surgery, which may influence the decision to use blood transfusion.