顎矯正手術における術中出血量および非輸血下での血液検査値の推移に関する検討

Abstract

It is difficult to predict the necessity of transfusion during orthognathic surgery. In order to examine the propriety of orthognathic surgery without preparing for transfusion, we examined 62 patients who underwent orthognathic surgery in our hospital during 3 years from January 2000 to December 2002, and performed statistical analysis of the blood loss and pre- and postoperative values of blood examination for each surgical procedure.The results were as follows:1. It seemed that a greater amount of blood is lost in double-jaw surgeries compared to single-jaw surgeries. There was a significant difference between the sagittal split ramus osteotomy combined with Le Fort I osteotomy group and the intraoral vertical ramus osteotomy group (P< 0.05). However, no case was indicated for transfusion intraoperatively.2. The larger the amount of blood lost in each surgery, the greater the decrease in values of blood examination (red blood cells, hemoglobin, hematocrit) at 1-week post-operation. A significant difference was found between pre-operation and 1-week post-operation except in the intraoral vertical ramus osteotomy group (P<0.05). Although the values tended to decrease slightly until 2-weeks post-operation, no general complication occurred.These results indicate that there is little risk of remarkable bleeding in routine orthognathic surgery. Therefore, it seems appropriate to carry out the operation without preparing for transfusion.