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| 題 名 | 顎面整形手術患者術前自體捐血政策之評估=The Assessment of Preoperative Autologous Blood Donation Program for Oral and Maxillofacial Surgery |
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| 作 者 | 楊茜淳; 吳哲輝; 宋詠娟; 黃仰仰; | 書刊名 | Journal of Biomedical & Laboratory Sciences |
| 卷 期 | 19:4 2007.12[民96.12] |
| 頁 次 | 頁117-123 |
| 分類號 | 415.652 |
| 關鍵詞 | 術前自體捐血; 顎面整形手術; Preoperative autologous blood donation; Oral and maxillofacial surgery; |
| 語 文 | 中文(Chinese) |
| DOI | 10.30046/JBLS.200712.0003 |
| 中文摘要 | 由於擔心異體輸血可能傳染疾病,所以顎面整形手術病患大部分會進行術前自體捐血,但自體捐血的使用仍有一些爭議。本研究是評估本院顎面整形手術病患現行的術前自體捐血政策,在臨床上的運用是否合適。我們收集從2005年1月至2006年7月的顎面整形手術病患共有77人完成手術前自體捐血,設爲研究組;另有2001年1月至2006年7月接受顎面整形手術而未參與術前自體捐血的病人,總共40人當作對照組。顎面整形手術病患開刀術式分爲Anterior Subapical Osteotomy (ASO)、Bilateral Intraoral Vertical Ramus Osteotomy (BIVRO)、Genioplasty (Gep)、Le Fort Ⅰ或兩種以上術式結合。我們採用病歷回顧方法收集病患捐血前血紅素(Hb)、手術前自體捐血量、手術後一天血紅素、術中失血量及輸用血量等數值,試圖來評估現行政策是否合適。各種術式的術中失血量分別爲BIVRO:196±102ml、BIVRO+Gep:419±195ml、ASO:341±171ml、ASO+Gep:479±311ml、其他或2種以上術式結合:511±249ml。接受異體輸血的病患在研究組有5人(6.5%),對照組有9人(22.5%)。研究組的病患一共有89.6%接受輸血,而對照組則只有22.5%輸血。研究組的病患接受輸血的機會較高,可能原因是輸血標準較寬鬆,或是手術前自體捐血造成術前血紅素偏低,致使病患手術中貧血,而增加輸血之可能性。我們的研究結果顯示,術前自體捐血計劃可以降低異體輸血機率,但對於術中失血量少、捐血前血紅素較高的病患效益不高。 |
| 英文摘要 | The risk of transfusion-transmitted-infection diseases from allogeneic blood had led to the popularization of preoperative autologous blood donation (PABD) in patient who required maxillofacial surgery. Despite the widespread acceptance of PABD by clinicians and patients, some controversies exist regarding the optimal use of this intervention. A retrospective analysis of 117 consecutive patients who had oral and maxillofacial surgery. For each patient referred the unit numbers of autologous blood donated, the transfusion unit numbers, baseline hemoglobin, one day postoperative hemoglobin, and intraoperative blood loss to assess whether the current policy of PABD was clinically appropriate for major oral and maxillofacial surgery procedure. We collected 77 patients as study group that underwent maxillofacial surgery with PABD from January 2005 to July 2006, and 40 patients as control group that underwent maxillofacial surgery without PABD from January 2001 to July 2006. The maxillofacial surgeries were classified as: anterior subapical osteotomy (ASO), bilateral intraoral vertical ramus osteotomy (BIVRO), genioplasty (Gep), Le Fort Ⅰ and combination of any two orthognathic procedures. The intraoperative blood loss respectively were BIVRO: 196±102 ml; BIVRO+Gep: 419±195 ml; ASO: 341±171 ml; ASO+Gep: 479+311 ml; other orthognathic procedures or combination of any two orthognathic procedures: 511±249 ml. The allogeneic transfusion rate was 6.5% and 22.5% in the study and control group; the overall rate of transfusion was 89.6% in the study group and 22.5% in the control group. The higher percentage of patient receiving transfusion in the study group might be due to some reasons; such as more liberal transfusion criteria, or preoperative anemia by PABD that caused to intraoperative anemia and increased transfusion possibility. In conclusion, we revealed PABD might decrease the possibility of allogenic transfusion. However, PABD was not cost-effective in the population with relatively low blood loss and higher preoperative hemoglobin concentration. |
本系統中英文摘要資訊取自各篇刊載內容。