CAJ | 학술논문

　　目的根据口内切口下颌角截骨术出血的特点和下颌角周围血管解剖判断血管的损伤情况，有针对性的进行进行止血。方法术中给与输红细胞悬液、快速补液及补充胶体。面动脉或分支损伤出血，采取电凝止血、结扎两个断段止血，或用大角针四号线进行缝扎止血。咬肌出血，用纱布压迫或电凝止血止血。下颌后静脉损伤出血，口内找到出血点缝扎止血。或从耳垂后做切口，钝性分离至下颌升支后缘找到血管并结扎。结果20例下颌角截骨术中大出血病例，止血彻底，均在第三天引流量少于5ml拔出引流管。结论根据口内切口下颌角截骨术出血的特点和下颌角周围血管的解剖学判断血管的损伤情况，可以进行快速、有效的止血，方法可靠、止血彻底。
　　목적근거구내절구하합각절골술출혈적특점화하합각주위혈관해부판단혈관적손상정황，유침대성적진행진행지혈。방법술중급여수홍세포현액、쾌속보액급보충효체。면동맥혹분지손상출혈，채취전응지혈、결찰량개단단지혈，혹용대각침사호선진행봉찰지혈。교기출혈，용사포압박혹전응지혈지혈。하합후정맥손상출혈，구내조도출혈점봉찰지혈。혹종이수후주절구，둔성분리지하합승지후연조도혈관병결찰。결과20례하합각절골술중대출혈병례，지혈철저，균재제삼천인류량소우5ml발출인류관。결론근거구내절구하합각절골술출혈적특점화하합각주위혈관적해부학판단혈관적손상정황，가이진행쾌속、유효적지혈，방법가고、지혈철저。
objective Acording to the characteristics of bleeding and the mandibular angle peripheral vascular anatomy to judge w hich vas-cular was damaged ,we can targete to hemostasia ,during the mandibular angle osteotomy incision from mouth .M ethod The patient was giv-en transfused RBC suspension ,rapid infusion and colloid during operation .if the facial artery or branches was injuried ,we could have taked coagulate ,ligated of the two broken segments or sutured with big horn needle and IV line to stop bleeding .if the masseter was injurued to bleeding ,we could have stopped bleeding with gauze or coagulating .if the mandibular vein was injuried ,we could have found the bleeding point and sutured to stop bleeding in the mouth ,or incised the skin behind the earlobe and dissected the soft tissiue to the trailing edge of the tlower mandible to find vascular and ligate .Result The 20 patients w ho blood severity during operation were stopped bleeding completely ,and the drainage tube was pulled out in the third day after operation ,w hen the drainage was less than 5ml .Conclusion We can stop bleeding fast-ly and effectively ,acording to the characteristics of bleeding and the mandibular angle peripheral vascular anatomy to judge w hich vascular was damaged .The method is reliable .