Abstract:
Surgery for excision of juvenile nasopharyngeal angiofibroma (JNA) carries the possibility of massive life-threatening haemorrhage. Anaesthetic management aims to maintain haemodynamic stability and reduce blood loss. This case series describes the application of the bundled approach as a multimodal blood loss prevention bundle (MBLPB). Twenty patients underwent 23 surgeries with MBLPB. The blood loss and the number of units of blood transfused were recorded. The surgeon satisfaction score was assessed. The median [interquartile range (IQR)] estimated blood loss was 1300 (650-2350) ml. Patients with tumours in stages I and II had a median (IQR) blood loss of 550 (270-750) ml compared to patients with higher grades of tumours (stages III, IV) with a median (IQR) blood loss of 2100 (1300-2500) ml. Median (IQR) units of packed red cells transfused was 1 (0-3). The surgeon\'s satisfaction score was high when MBLPB was applied for JNA. However, it does not appear to reduce blood loss markedly.
摘要:
切除青少年鼻咽血管纤维瘤(JNA)的手术可能会导致大量危及生命的出血。麻醉管理旨在维持血流动力学稳定并减少失血。本案例系列描述了捆绑方法作为多模态失血预防束(MBLPB)的应用。20例患者接受了23例MBLPB手术。记录失血量和输血单位数。评估外科医生满意度评分。估计失血量的中位数[四分位距(IQR)]为1300(650-2350)ml。与肿瘤等级较高的患者相比,I期和II期肿瘤患者的中位(IQR)失血量为550(270-750)ml(III期,IV),中位(IQR)失血量为2100(1300-2500)ml。输注的堆积红细胞的中值(IQR)单位为1(0-3)。当MBLPB应用于JNA时,外科医生的满意度得分较高。然而,它似乎并没有显着减少失血。