生物蛋白胶在颈部内镜甲状腺切除术中的应用及效果分析  

Application and and Effect of Fibrin Glue in the Neck Endoscopic Thyroidectomy

作　　者：王进超 蔡胜华 

机构地区：[1]武汉经济技术开发区沌口医院外科,武汉430056

出　　处：《医学综述》2016年第7期1410-1411,1414,共3页Medical Recapitulate

摘　　要：目的探究生物蛋白胶在颈部内镜甲状腺切除术中的应用及止血效果。方法选择2012年7月至2014年7月武汉经济技术开发区沌口医院接治的行颈部内镜甲状腺切除术的患者78例,按随机数字表法分为两组。观察组37例采用生物蛋白胶配合引流管引流,对照组41例采用引流管引流,观察两组患者术后的第1日引流量及总引流量、引流管拔除的时间、切口拆线的时间、切口愈合情况及术后不良反应。结果观察组患者术后第1日引流量、总引流量、引流管拔除时间、切口拆线时间均显著低于对照组[(35.1±2.4)mL比(44.6±4.3)mL,(48±4)mL比(80±78)mL,(17.7±1.6)h比(25.8±2.4)h,(4.4±0.6)d比(5.3±1.5)d],差异有统计学意义(P<0.05)。观察组患者在切口粘连和术后感染发生率显著低于对照组[0%比19.5%(8/41),0%比14.6%(6/41)],差异有统计学意义(P<0.05),在声音嘶哑、颈部肿胀、吞咽时牵拉感发生率比较,差异无统计学意义(P>0.05)。结论甲状腺手术中应用上生物蛋白胶不仅能明显减少引流液,而且还能降低患者术后的感染率,并促进切口的愈合。Objective To explore the application and hemostatic effect of fibrin sealant in the neck endoscopic thyroidectomy. Methods Total of 78 patients undergoing routine neck endoscopic thyroidectomy in Tunkou Hospital of Wuhan Economy and Technology Development Zone from Jul. 2012 to Jul. 2014 were divided into two groups according to random number table method： the 37 cases of observation group used fibrin glue with the drainage tube,the 41 cases of control group used the drainage tube,the drainage on the first day after surgery and total drainage,drainage tube removal time,stitches removal time,incision recovery and adverse postoperative symptoms of the two groups were compared. Results The drainage amount on the first day after surgery,the total drainage,drainage tube removal time,incision stitches removal time of the observation group were significantly lower than the control group[（ 35. 1 ± 2. 4） mL vs（ 44. 6 ± 4. 3） mL,（ 48 ± 4） mL vs（ 80 ± 8） mL,（ 17. 7 ± 1. 6） h vs（ 25. 8 ± 2. 4） h,（ 4. 4 ± 0. 6） d vs（ 5. 3 ± 1. 5） d,P 〈0. 01]. Cut adhesions and postoperative infection rate of the observation group were significantly less than the control group[0% vs 19. 5%（ 8 /41）,0% vs 14. 6%（ 6 /41） ]（ P 〈 0. 05）,the incidences of hoarseness,neck swelling and swallow pulling of the two groups had no significant difference（ P 〉 0. 05）. Conclusion Fibrin glue applied in thyroid surgery can not only significantly reduce the drainage,but also reduce postoperative infections and promote wound healing.

关 键 词：颈部内镜甲状腺切除术 生物蛋白胶 止血效果 

分 类 号：R653[医药卫生—外科学]