Abstract: PURPOSE: To discuss the perioperative prophylaxis for children with cleft palate and coagulation disorders in order to improve surgical safety. METHODS: A retrospective study was conducted between November, 2011 and November, 2019 from the Department of Pediatric Surgery, Shanghai Children's Medical Center, identified 38 patients with cleft palate, among whom 19 were complicated with coagulation disorders (abnormal group) and 19 were included as control. Six of 19 patients in the abnormal group were previously diagnosed hemophilia (3 were hemophilia A, 2 were hemophilia B, 1 was hemophilia C),and the remaining 13 patients were first diagnosed with abnormal coagulation by routine preoperative examinations. All patients in the abnormal group underwent prophylactic blood substitution with blood coagulation factors, prothrombin complex concentrate or fresh frozen plasma before surgery. The average surgery time, intraoperative blood loss and average hospitalization days were statistically analyzed with SPSS 22.0 software package. RESULTS: In the abnormal group, 18 of 19 patients' APTT improved obviously before surgery,and underwent surgical treatment successfully and recovered without any surgical complications after prophylactic blood substitution. One patient suffered from hemorrhage of about 250 mL and had fully recovery after intraoperative PPSB, plasma and red blood cell treatment. The intraoperative blood loss and average hospitalization days between the two groups had no significant difference(P>0.05). CONCLUSIONS: Appropriate application of perioperative blood substitution can effectively reduce intra- and post-operative bleeding for patients with cleft palate and coagulation disorders and improve surgical safety.

Key words: Cleft palate, Coagulation disorder, Blood substitution, Children, Perioperative period