Establishment of Preoperative Maximum Blood Order Schedule for Maxillofacial Malignant Tumor Patients Undergoing Free Flap Reconstruction
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2022.0517
- VernacularTitle:新型术前最大备血量的建立在行游离皮瓣重建术的颌面部恶性肿瘤患者的研究
- Author:
Yi-li ZHAO
1
;
Dan-dan LI
1
;
Yan-ling LI
1
;
Yan ZHANG
1
;
Yan WANG
2
;
Yan-hong CHEN
1
Author Information
1. Department of Blood Transfusion， Sun Yat-sen Memorial Hospital， Sun Yat-sen University， Guangzhou 510120， China
2. Department of Oral and Maxillofacial Surgery， Sun Yat-sen Memorial Hospital， Sun Yat-sen University， Guangzhou 510120， China
- Publication Type:Journal Article
- Keywords:
free-flap reconstruction;
Maxillofacial malignant tumor;
maximum surgical blood order schedule （MSBOS）
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2022;43(5):828-836
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo establish the maximum blood order schedule （MSBOS） for maxillofacial malignant tumor surgery of patients undergoing free flap reconstruction so as to guide clinicians in using blood rationally and prepare blood scientifically by the department of blood transfusion. MethodsBasic information and blood transfusion data of patients in the perioperative period of maxillofacial surgery in our hospital from January 1， 2010 to December 31， 2020 were collected， including age， gender， body mass index （BMI）， preoperative hemoglobin value， ASA staging， T staging， and whether the free flap contains bone flaps， surgical methods （category 6）， the amount of blood ordered for preparation， and the amount of blood used in the operation. A total of 1 953 cases of elective surgery in maxillofacial surgery were included. The univariate and multivariate logistic regression analyses of perioperative transfusion were performed to screen out independent risk factors for perioperative transfusion and establish scoring criteria. According to the surgical method， the patients were divided into 6 groups， then each group of patients was further divided into low-risk， intermediate-risk and high-risk groups in accordance with scoring standard. The cumulative percentage of the actual intraoperative blood transfusion frequency of each group of patients was calculated to establish the MSBOS of the maxillofacial surgery patients. Results①Regression analysis found that BMI， tumor T staging， ASA grade， preoperative hemoglobin （Male Hb < 130 g/L， female Hb < 120 g/L）， and free flaps containing bone flaps were independent risk factors for perioperative blood transfusion. ②According to risk factor scores， it was found that the low-risk group had the lowest blood transfusion rate， but cross match to transfusion ratio was the highest. ③The MSBOS of maxillofacial malignant tumor patients who underwent free flap reconstruction in our hospital was established. The analysis found that after MSBOS was established，the total amount of blood prepared before the operation could theoretically be reduced by 54.35% than before the establishment. ConclusionThe establishment of MSBOS is not only beneficial for guiding the blood preparation more scientifically and reasonably， but also can optimize the management of blood inventory and save blood resources.
