http://dx.doi.org/10.5125/jkaoms.2011.37.4.272 272 Ⅰ.  론 구강악안면 영역에 악교정은 악안면의 부정교합 과 비대칭을 가진 환자들에 대한 외과적 식으로 심미 및 기능의 회복을 위해 사용되는 식이다. 후 많은 부작용 이 발할  있으며, 안면부의 감각실 및 출혈, 호흡곤 란 및 악안면기형의 재발 등을 들  있다 1 . 합병증들 중에  출혈은 중이나 후에 환자에게 매우 치명적일  있 는 합병증이다. Rohling 등 2 은 출혈을 예방하기 위해 여러 가지 혈액실 방지방법을 발표했다. 전에 이용할  있는 방법으로는 자가혈액의 예치, 철분의 복용을 통한 조혈작용의 촉진이 있으며 중에는 외상을 최화하는 적 접근, 저혈압 마취, 부위의 심장보다 상방으로의 위치, 급동량 혈액 희 등이 포함되어 있다. Rohling 등 2 의 연구에는 위에 나열한 방법들을 통해 127명의 양악 환자에  자가혈을 예방할  있었다고 보고하였다 2 . 특히 저혈 김선종 158-050 울특별시 양천구 목동 911-1번지 이화여자대학교 의학전문대학원 치과학교실 구강악안면외과 Sun-Jong Kim Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University Mokdong Hospital 911-1 Mok-dong, Yangcheon-gu, Seoul, 158-050, Korea TEL: +82-2-2650-5041 FAX: +82-2-2650-5764 E-mail: sjsj7777@ewha.ac.kr 다양한 악교정 식 조합에 따른 실혈양의 비교 연구 장진현ㆍ김진우ㆍ박호ㆍ김명래ㆍ김종 이화여자대학교 의학전문대학원 치과학교실 구강악안면외과 Comparative study on the estimated blood loss follwing to orthognathic surgeries Jin-Hyun Jang, Jin-Woo Kim, Sung-Ho Park, Myung-Rae Kim, Sun-Jong Kim Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, Korea Purpose: The aim of this study was to compare the estimated blood loss and determine the change in hemoglobin depending on the combination of each orthognathic surgery. Subjects and Methods: The subjects of this study were patients who underwent orthognathic surgery among those diagnosed with a dentofaical deformity in Mok-Dong hospital, Ewha Womans University from 2002 to 2009. One hundred patients (men - 36, women - 64, mean age of 24.5±4.6) participated in the study and were divided into four groups (group 1 - bilateral sagittal ramus osteotomy [BSSRO], group 2 - BSSRO+Genioplasty, group 3 - Lefort 1+BSSRO+genioplasty, group 4 - anterior segmental osteotomy on maxilla and mandible). A comparative study on the estimated blood loss (EBL), operation time, peri-operative changes in hemoglobin was performed using anesthesia records. The results were analyzed statistical- ly using a Mann-Whitney U-test and Spearman’ s Rho test - SPSS 12.0 (SPSS Inc. Chicago, IL, USA). Results: In group 1 (BSSRO), the mean EBL, operation time and change in hemoglobin was 394.43±52.69 ml, 184±42.33 minutes, and 1.43, respectively, In group 2 (BSSRO+genioplasty), it was 556.32±63.42 ml, 231±37.45 minutes, and 1.80, respectively. In group 3 (Lefort 1+BSS- RO+Genioplasty), it was 820.55±105.54 ml, 320±15.41 minutes, and 2.73, respectively. In group 4 (segmental osteotomy), it was 1025.39±160.21 ml, 355±20.10 minutes, and 3.33, respectively. In particular, in group 3, significant differences were observed depending on the method of the orthognathic surgery. The mean EBL in a Lefort 1 osteotomy with advancement was only 687 ml, whereas Lefort 1 osteotomy with canting correction (992 ml), even impaction (764 ml), and posterior nasal spine impaction (100 ml) showed a much higher EBL. Conclusion: From these results, the EBL and peri-operation hemoglobin increased as treatment plans became more complicated and increasing operation time. Safe orthognathic surgery should be performed by applying proper autologous transfusion plans based on the average EBL of each orthognathic surgery type. Key words: Estimated Blood Loss, Orthognathic surgery, Hemoglobin change [paper submitted 2011. 3. 27 / revised 2011. 7. 21 / accepted 2011. 7. 26] Abstract (J Korean Assoc Oral Maxillofac Surg 2011;37:272-7)