狭颅症儿童颅骨修补术中出血量的影响因素
姜静, 卞勇, 郑吉建, 黄悦

Factors influencing the amount of blood loss in pediatric patients during craniosynostosis surgery
JIANG Jing, BIAN Yong, ZHENG Jijian, HUANG Yue
表1 儿童狭颅手术术中大出血的单因素分析
Tab 1 Univariate analysis of massive bleeding in pediatric patients during craniosynostosis surgery
Item

Massive bleeding

group (n=215)

Non-massive bleeding group (n=24)Z/χ2 valueP value
Gender/n(%)0.9410.332
Male140 (65.1)18 (75.0)
Female75 (34.9)6 (25.0)
Age/month11 (7, 21)22 (10, 30)-2.3010.021
Weight/kg9.6 (8.4, 11.0)12.0 (10.1, 13.8)-3.0890.002
Body length/cm75 (70, 82)85 (74, 94)-3.4360.001
Previous craniofacial surgery/n(%)14 (6.5)3 (12.5)1.1720.507
Syndromic/n(%)12 (5.6)1 (4.2)0.0840.772
Hydrocephalus/n(%)10 (4.7)0 (0)1.1650.590
Family history/n(%)2 (0.9)0 (0)0.2250.642
Duration of symptom/month9 (6, 17)14 (6, 24)-1.9010.057
Preoperative Hb/(g·L-1)121 (113, 126)125 (116, 130)-1.3690.171
Preoperative hematocrit/%36.45 (38.00, 34.10)37.20 (38.90, 35.30)-1.6640.096
Preoperative albumin/(g·L-1)41.4 (39.5, 44.2)42.7 (39.9, 44.0)-0.5840.559
Lowest temperature in operation/℃35.6 (35.0, 36.1)36.1 (35.2, 36.4)-2.1310.033
Duration of surgery/min215.5 (184.0, 243.0)216.0 (176.0, 251.0)-0.3670.713
Amount of crystalloid and colloids infusion/mL350 (200, 500)400 (263, 575)-0.7630.446
Amount of blood products using
RBC transfusion/mL300 (200, 300)150 (150, 300)-3.1690.002
Plasma transfusion/mL100 (0, 100)100 (0, 100)-1.5060.132
FFP/n(%)7 (3.3)0 (0)1.4301.000
Cryoprecipitate/n(%)8 (3.7)0 (0)0.9241.000
Use of hemostatic drugs/n(%)
Hemocoagulase injection111 (5.2)8 (3.3)2.8900.089
Tranexamic acid18 (8.3)0 (0)2.1730.140
PPSB13 (6.0)0 (0)1.5350.373
Number of sutures/n(%)4.1480.126
1134 (62.3)10 (45.8)
264 (29.8)12 (50.0)
≥317 (7.9)1 (4.2)
Craniosynostosis type/n(%)13.2680.010
Scaphocephaly64 (29.8)6 (25.0)
Brachycephaly16 (7.4)2 (8.3)
Trigonocephaly39 (18.1)3 (12.5)
Plagiocephaly17 (7.9)1 (4.2)
Multiple79 (36.7)12 (50.0)
Type of operation/n(%)8.4820.033
CVR117 (54.5)15 (62.5)
FOA8 (3.7)2 (8.3)
CVR+FOA87 (40.5)5 (20.8)
Others3 (1.4)2 (8.3)