正颌外科手术中出血量和术后肿胀程度的多因素相关性研究.DOCVIP

临床医学论文-正颌外科手术中出血量和术后肿胀程度的多因素相关性研究 ?????????????????????作者：唐正龙，王兴，伊彪, 李自力, 梁成? 【摘要】? 　　目的： 探讨正颌外科手术中出血量和术后肿胀程度的影响因素及其相关性。方法： 87例行相同正颌外科术式的患者，根据术前是否服用云南白药分为试验组和对照组。将术中出血量和术后肿胀程度与体重、身高、手术时间等因素作相关性统计分析和回归分析，并建立预测出血量和肿胀程度的回归方程。结果： 试验组出血量和肿胀程度均低于对照组，有统计学意义；两组出血量与手术时间有正相关关系(实验组R=0.280,P=0.035；对照组R=0.515,P=0.001)；对照组出血量还与身高有一定的相关关系（r=0.347,P=0.049）；术后肿胀程度与出血量（rs =0.251,P=0.019）、手术时间(rs =0.211,P=0.050)有相关关系。肿胀程度Logistic回归概率方程为P=e0.004×出血量-1.258/1+e0.004×出血量-1.258。结论： 在相同术式和麻醉控制条件下，影响正颌外科出血量的主要因素是手术时间，术后肿胀程度的主要影响因素是出血量和手术时间；术前应用止血抗炎药物对减少出血量和减轻肿胀程度具有重要作用。 【关键词】? 口腔外科手术； 失血，手术； 肿胀 　　［Abstract］Objective: To investigate the influencing factors and their relationship with blood loss and facial swelling in orthognathic surgery. Methods: Eighty-seven patients scheduled for orthognathic surgery were randomly divided into two groups according to whether received prophylactic administration of Yunnan Baiyao (experimental group) or not (control group). Correlation and regression analysis were performed between the parameters (age, height, weight and surgical time) and the amount of blood loss and degree of facial swelling in the two groups. Results: There were significant differences in blood loss and facial swelling between the two groups. Significant positive correlation was found between the surgical time and the amount of blood loss (experimental group: R=0.280, P=0.035；Control group: R=0.515, P=0.001) in the two groups, and there was correlation between the body height and blood loss in control group (r=0.347, P=0.049）. The postoperative facial swelling was correlated with blood loss（rs =0.251,P=0.019）and surgical time (rs =0.211,P=0.050). The Logistic equation of facial swelling was P=e0.004×amount of bleeding -1.258/1+e0.004×amount of bleeding -1.258. Conclusions: Under the same conditions of surgical and anesthesia procedures, the major factor influencing blood loss is surgical time, and the variables affecting facial swelling are surgical time and the amount of blood loss. Pro