肾上腺素联合单极喷凝在甲状腺全切除术止血中的应用  

Application of adrenaline combined with monopole spray electrocoagulation in hemostasis of total thyroidectomy

作　　者：刘钢[1] 胡如进[1] 马建赢 LIU Gang;HU Ru-jin;Ma Jian-ying(Department of Breast Thyroid and Pancreatis Surgery,Huangshi Central Hospitalof Edong Healthcare Group（Affiliated Hospital of Hubei Polytechnic University）,Huangshi Hubei 435000,China)

机构地区：[1]鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)乳甲胰腺外科,湖北黄石435000

出　　处：《局解手术学杂志》2018年第9期674-677,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：湖北省黄石市科技攻关项目[黄科技农发(2006)1号]

摘　　要：目的探讨肾上腺素联合单极喷凝在开放性甲状腺全切手术止血中的临床应用。方法回顾性分析鄂东医疗集团黄石市中心医院2014年1月至2017年12月收治的638例开放性甲状腺全切除术的临床资料,根据4种止血方式分为4组,即常规组(不用肾上腺素及单极喷凝) 156例,肾上腺素组(单用肾上腺素) 160例,单极喷凝组(单用单极喷凝) 163例,肾上腺素+单极喷凝组(联用肾上腺素及单极喷凝) 159例;对4组患者术后出血发生率、术后声嘶发生率及术后低钙血症发生率进行比较;对其中16例发生术后出血的病例进行临床分析,比较不同方法止血的临床效果。结果肾上腺素组、单极喷凝组及肾上腺素联合单极喷凝组患者术后出血发生率均低于常规组,差异具有统计学意义(P <0. 05);肾上腺素组、单极喷凝组及肾上腺素联合单极喷凝组患者术后声嘶发生率及低钙血症发生率与常规组比较,差异无统计学意义(P> 0. 05)。结论术中应用肾上腺素、单极喷凝或两种方法联合应用有利于降低甲状腺开放性全切术后出血发生率,具有安全性和可行性。Objective To investigate the clinical application of combination of adrenaline with monopole spray electrocoagulation in hemostasis of total thyroidectomy. Methods The clinical data of 638 patients underwent open total thyroidectomy from January 2014 to December 2017 in Huangshi central hospital of Edong healthcare group were retrospectively analyzed,who were divided into 4 groups according to hemostasis method,156 cases in control group,160 cases in adrenaline group,163 cases in monopole spray electrocoagulation group,159 cases in adrenaline combined with monopole spray electrocoagulation group.The incidence of postoperative bleeding,the incidence of postoperative hoarseness and the incidence of postoperative hypocalcemia in 4 groups were compared,of which 16 cases developing postoperative hemorrhage and accepting the above-mentioned hemostasis were picked and analyzed. Results The occurrence rate of postoperative hemorrhage in adrenaline group,molopole spray electrocoagulation group and combination group was all lower than that in the control group,and the differences were significant（ P 〈0.05.There was no difference in the occurrence rate of hoarseness and hypocalcemia between control group and other three groups. Conclusion The application of using adrenaline or monopole spray electrocoagulation or the combination of above-mentioned two approaches are avail of reducing the postoperative hemorrhage rate in open total thyroidectomy and it is safe and feasible.

关 键 词：甲状腺切除术 手术后出血 肾上腺素 电凝术 

分 类 号：R619.1[医药卫生—外科学]