甲状腺术后出血的位置及原因分析  

Location and reason of pos-thyroidectomy hemorrhage

作　　者：龙森云[1] 黎洪浩[1] 林俊双 彭新治[1] 黄明清[1] 罗定远[1] 

机构地区：[1]中山大学附属孙逸仙纪念医院甲状腺外科,广州510120 [2]广东省郁南县人民医院普通外科

出　　处：《临床外科杂志》2013年第2期113-115,共3页Journal of Clinical Surgery

基　　金：广东省自然科学基金资助项目（编号：8451008901000481）;中山大学医科青年教师科研启动基金资助项目（编号：2007014）

摘　　要：目的探讨甲状腺术后出血的部位和原因。方法回顾性分析2008年8月至2011年8月进行的甲状腺手术2950例中需要再次手术止血的26例临床资料，对其出血的诱因、出血部位及出血量等有关特点进行分析。结果甲状腺术后出血主要在术后24h（92．2％）内发生，其中6～12h占53．8％。出血的原因为咳嗽与呕吐（19．2％）、卧床时颈部的过度活动（26．9％）、起床活动（15．4％）及更换敷料操作（15．4％）。出血的主要部位为颈前肌（50％）、甲状腺血管（19．2％）、残余甲状腺（15．4％）和皮下及颈阔肌（11．5％）。结论提高对甲状腺术后出血的诱因及部位的认识，将有利于防治甲状腺术后出血及其出血后的处理。Objective To discuss the location and reason of post-thyroidectomy hemorrhage. Methods The study involved a retrospective chart review of 2950 thyroid operations from August 2008 through August 2011 ;26 cases of them, who were re-explored due to the development of hematomas, were enrolled and studied. The incentive, location and amount of the hemorrhage were analyzed. Results Most of the post-thyroidectomy hemorrhage happened in the first 24 h after surgery（92.2% ） and 53.8% of the hemorrhage happened between 6h to 12h after surgery. The incentives of the hemorrhage included severe coughing and vomiting（ 19.2% ）, excessive activity of neck （26.9%）, getting up from the bed （ 15.4% ） and changing the dressing（ 15.4% ）. The locations of the hemorrhage included anterior cervical muscles （50%） ,thyroid blood vessels （ 19.2% ）, residual thyroid （ 19.2% ） subcutaneous tissues and platysma （ 11.5% ）. Conclusion Understanding of the incentives and locations for post-thyroidectomy hemorrhage should be improved, which may be helpful in preventing and managing the hemorrhage.

关 键 词：甲状腺手术 出血 原因 位置 

分 类 号：R656.7[医药卫生—外科学]