甲状腺切除术后出血风险因素分析与护理对策  

The hemorrhage risk factors and nursing strategy analysis in patients after thyroidectomy

作　　者：朱燕华[1] 刘汉伟[2] 陈超琳[3] 黄小玲[4] 

机构地区：[1]中山大学附属第五医院普外三科,广东519000 [2]中山大学附属第五医院神经科,广东519000 [3]中山大学附属第五医院手术室,广东519000 [4]中山大学附属第五医院肺功能室,广东519000

出　　处：《中国急救复苏与灾害医学杂志》2014年第7期627-629,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨和分析甲状腺切除术后出血风险因素与护理对策。方法226例接受甲状腺手术切除的患者，记录患者的临床资料，出血量超过40ml和持续出血超过48h视为出血阳性患者，采用统计分析患者的年龄、性别、基础疾病、手术刀类别和切除组织大小等与出血的相关性。结果入组患者中出血阳性者有41例，研究显示用传统刀手术、切除组织大、血清炎症因子升高者出血增加，高血压和糖尿病是患者术后出血的独立风险因素，年龄和性别与出血无明显相关。结论甲状腺切除患者术后出血与手术刀类别、切除组织大小、基础病和血清炎症水平相关，对基础病多、传统刀手术、切除组织大且血清炎症因子升高的患者术后应加强床边护理。Objective To explore and analyze the bleeding risk factors and nursing points for the patients after thyroideetomy. Methods An analysis was performed on 226 patients after thyroidectomy. Positive bleeding patients were identified as those bleeding more than 40 ml for more than 48 hours. The correlation on the factors of age, gender, underlying disease, scalpel categories and the reseeted tissue sizes with bleeding were explored by regression analysis. Results 41 of them with thyroideetomy were identified as positive hemorrhage. The analysis reflected a higher chance for bleeding when using traditional scalpel in the operation, reseeting more thyroidt tissues and higher serum inflammatory faetores post-operation. Hypertension and diabetes was an independent risk factor of hemorrhage after thyroidectomy. It also showed no correlation between age, gender and hemorrhage. Conclusion The basic diseases, scalpel categories, resection tissue size and serum level of inflammation factors have a positive relationship with post-operation hemorrhage of patients with thyreoidectomy. The intensive care nursing may be required for those post-operation patients who suffer from multiple basic diseases and tissue resection and are used traditional scalpel for operation and high serum inflammatory factor.

关 键 词：甲状腺 切除 床边护理 出血 护理对策 

分 类 号：R581[医药卫生—内分泌]