结节性甲状腺肿手术感染的预防  

Treatment of relapse of nodular goiter and prevention of infections

作　　者：王介营[1] 李芹[1] 王洪辉[1] 王玉虎[1] 

机构地区：[1]滨州市中心医院外二科,山东滨州251700

出　　处：《中华医院感染学杂志》2013年第15期3669-3671,共3页Chinese Journal of Nosocomiology

基　　金：滨州市科技局科研项目(JB2010-3-065-1)

摘　　要：目的探讨结节性甲状腺肿手术后复发再治疗及感染预防,以有效控制并发症的发生。方法选取2010年6月-2012年6月接受诊断和复发再治疗的结节性甲状腺肿患者48例作为观察组,另选取同期接受诊断和治疗并且未出现复发的结节性甲状腺肿患者48例作为对照组,比较两组患者的诊断结果、观察组患者两次手术的并发症发生以及接受感染预防的患者手术感染发生率。结果观察组患者误诊率为33.33%,明显高于对照组的20.83%(P<0.05);观察组患者手术方式多采用单纯的结节摘除,占50.00%,明显高于对照组的37.50%(P<0.05);观察组患者再次手术并发症的发病率为4.17%,明显低于首次手术的10.42%(P<0.05),观察组患者手术感染的发生率为6.25%。结论结节性甲状腺肿手术后复发主要与误诊以及手术方式的选择有关,而再治疗原则主要包括并发症的控制以及手术时机的选择等,感染预防措施可有效预防手术感染的发生。OBJECTIVE To discuss the treatment of relapse of nodular goiter and prevent the postoperative infec- tions so as to effectively control complications. METHODS A total of 48 cases of patients who received the diagno- sis and the treatment of relapse of nodular goiter between Jun 2010 to Jun 2012 were selected as the observation group, while 48 cases of patients without relapse of nodular goiter were set as the control group, then the diagnos- tic result was compared between the two groups, and the incidence of complications of the observation group and the incidence of surgical infections were analyzed. RESULTS The misdiagnosis rate of the observation group was 33.33%, significantly higher than 20.83% of the control group （P〈0.05） ; most of the cases in the observation group adopted the simple removal of the nodules, accounting for 50.00%, significantly higher than 37.50% of the control group （P〈0.05）. The incidence of complications of the reoperation was 4.17% in the observation group, significantly lower than 10.42% of the initial surgery （P〈0. 05）. The incidence of surgical infections was 6.25% in the observation group. CONCLUSION The recurrence of nodular goiter after surgery is mainly related to the misdiagnosis or the surgery approach, and the re-treatment principles mainly include the control of complications and the choice of timing of surgery, the surgical infections can be prevented through effective prevention measures,

关 键 词：结节性甲状腺肿 手术 复发 再治疗 

分 类 号：R619.3[医药卫生—外科学]