446例双颌正颌术出血量相关因素的回顾性分析

Respective analysis of the related factors of the amount of bleeding in 446 patients undergoing bimaxillary orthognathic surgery

目的 探讨双颌正颌手术中患者出血量的相关影响因素。方法 收集2020年1月至2022年4月在南方医科大学口腔医院择期行上颌LeFortI型截骨术和双侧下颌升支矢状劈开截骨术(伴或不伴颏成形术)的446例患者的临床资料,记录性别、年龄、体质量、入室时(T0)与手术开始时(T1)、手术30 min时(T2)、手术结束时(T3)心率和血压、术中出血量、手术时间、术后拔管时间和麻醉药用量等参数。通过皮尔逊相关性分析影响出血量的相关因素。结果 出血量与性别有弱相关性(r=-0.1,P=0.033<0.05);出血量与体质量(r=0.123,P<0.01)、手术时间(r=0.428,P<0.001)、瑞芬太尼用量(r=0.23,P<0.001)、舒芬太尼用量(r=0.146,P<0.01)、顺苯磺酸阿曲库铵用量(r=0.201,P<0.001)、七氟醚用量(r=0.093,P<0.05)的相关性均有统计学意义;与年龄、丙泊酚用量、右美托咪定用量的相关性均未见统计学意义(P>0.05)。结论 出血量与性别、体质量、手术时间、瑞芬太尼用量、舒芬太尼用量、顺苯磺酸阿曲库铵用量、七氟醚用量用均有相关性。

Objective To investigate the related factors of intraoperative blood loss in patients undergoing orthognathic surgery. Methods The clinical data were collected from 446 patients who underwent elective maxillary LeFortI osteotomy and bilateral sagittal mandibular splitting osteotomy(with or without mentoplasty) from January 2020 to April 2022. Gender, age, body weight, heart rate and blood pressure at entering romm(T0), the beginning of surgery(T1), 30 min of surgery(T2), the end of surgery(T3), intraoperative blood loss(ml), operation time(t1), postoperative extubation time(t2), anesthetic dosage were recorded. Pearson correlation was used to analyze the influencing factors of blood loss. Results There was a weak correlation of blood loss with gender(r=-0.1, P=0.033<0.05). Blood loss was significantly correlated with body weight(r=0.123, P<0.01), operation time(r=0.428, P<0.001), remifentanil dosage(r=0.23, P<0.001), sufentanil dosage(r=0.146, P<0.01), atracurium cis-benzenesulfonate dosage(r=0.201, P<0.001), sevoflurane dosage(r=0.093, P<0.05). There was no significant correlation of blood loss with age, dosage of propofol and dosage of dexmedetomidine(P>0.05). Conclusions The amount of blood loss is correlated with sex, body weight, operation time, dosage of remifentanil, sufentanil, atracurium cisbenesulfonate and sevoflurane.