小儿腭裂整复术中失血与输液的临床研究  

The clinic study on the bleedness and transfusion in pediatrc patients with palatoplasty

作　　者：杨建平[1] 刘贻庆[1] 黄跃[1] 陈伟华[1] 李学山[1] 彭宝琴[1] 张青[1] 刘美绸[1] 

机构地区：[1]三明市第一医院口腔颌面外科,福建三明365000

出　　处：《临床口腔医学杂志》2004年第1期25-26,共2页Journal of Clinical Stomatology

基　　金：福建省三明市科技计划项目资助 (2 0 0 2 -L - 1 2 )

摘　　要：目的 :就小儿腭裂整复术中如何有效减少失血量及合理输液问题进行临床研究 ,为小儿手术后顺利康复提供依据。方法 :选择 2 -14岁腭裂修补术患儿 3 2例 ,术中不输血 ,仅输注 5 %葡萄糖液、平衡盐液、血浆代用品 ,分别观察手术开始 10、2 0、3 0min和术后 3 0min的Bp、HR、SPO2 及Hb、Hct变化并与术前基础值作比较 ;收集并统计术中失血量 ,比较使用或不使用高频电刀作腭部侧切口的失血量 ,进行统计学处理。结果 :围手术期SBp、DBp、HR等血液动力学指标及SPO2 变化无显著性差异 ( p >0 .0 5 )。Hb、Hct值有下降 ,但术后Hct值均大于 3 0 %。用高频电刀作腭部侧切口比不用高频电刀者的失血量明显减少 (P <0 .0 1)。结论 :小儿腭裂整复术中合理的输液组合可替代输血 ,能保证生命体征基本平稳 ,既节约血源 ,又避免输血可能带来的不良反应 ;高频电刀作腭部侧切口及电凝止血 ,是一种高效、安全的止血方法。Objective:To study how to reduce bleedness efficiently during the operation on the pediatric patient with palatoplasty and to study the rational combination of transfusion , in order to provide a basis for the postoperative recovery in children. Method: 32 cases without blood transfusion were selected from the Smile Train, aged from 2 to 14 years old. The combination of transfusion during the opertion was 5% glucose solution, balance solution and blood plasma substitute-HeSi. The intraoperative and postoperative circulation as blood pressure(Bp), heart rate (HR) ,hemoglobulin (Hb) ,hematocrit (Hct) , were compared with the preopertive data . The side cut of palate was made by high frequency electricity knife . The bleeding meas-ure of this method was compared with that of routine method .The data was dealed with statistics . Result: The index of the blood stream dynamics as SBp , DBp , HR ect , the change of SPO 2 were steady, without obvious difference from the data base (P>0.05) . The values of Hb and Hct descended , but postoperative Hct was 30 percent higher. The bleeding measure of using high frequency electricity knife (HFEK) was obviously reduced (P<0.01) .Conclusion:During palatoplasty in pediatric patients , the rational combination of transfusion could take the place of blood trasfusion and could assure steady of life sign. It could not only save the blood but also avoid the side effects of blood transfusion . The HFEK used for side cut and stoping blood was a high effect and safe method of stoping blood. It was good for clinic application extended .

关 键 词：腭裂整复术 输液 高频电刀 失血 

分 类 号：R782.2[医药卫生—口腔医学]