甲状腺手术中应用胶原蛋白海绵预防术后出血和切口粘连的有效性分析  

Analysis on Effectiveness of Collagen Sponge in Preventing Postoperative Bleeding and Incision Adhesion in Thyroid Surgery

作　　者：邱利飞[1] 孙启玉[1] 赵国军[1] QIU Lifei;SUN Qiyu;ZHAO Guojun(Affiliated Hospital of Chengde Medical College, Hebei Chende 067000, China)

机构地区：[1]承德医学院附属医院

出　　处：《河北医学》2019年第8期1374-1377,共4页Hebei Medicine

基　　金：河北省承德市科技支撑计划项目,(编号:20142065)

摘　　要：目的:研究甲状腺手术中应用胶原蛋白海绵预防术后出血和切口粘连的效果,为临床应用提供依据.方法:选取我院2017年10月至2018年6月收治的98例甲状腺手术患者为研究对象,随机分为两组,即观察组和对照组.观察组手术患者切除病变组织后应用超声刀及双极电凝镊彻底止血后,在手术创面和颈前肌群中间放入胶原蛋白海绵.对照组常规超声刀及双极电凝镊彻底止血后不放胶原蛋白海绵,观察手术后负压引流管引流量以及手术切口是否有渗血有粘连.结果:观察组患者手术后24h负压引流量14.64±6.18mL,低于对照组的负压引流量36.68±9.28mL,差异有统计学意义(P<0.05);观察组患者手术后48h负压引流量38.10±7.29mL,低于对照组的负压引流量56.12±8.67mL,差异有统计学意义(P<0.05);手术后切口渗血发生率观察组为4.08%,低于对照组的16.33%,差异有统计学意义(P<0.05);手术后3个月观察组患者切口粘连发生率为10.20%,明显低于对照组的26.53%,差异有统计学意义(P<0.05).结论:甲状腺手术中应用胶原蛋白海绵能有效预防术后出血和切口粘连,降低了术后出血的风险,降低了切口粘连发生率,具有较好的临床应用价值.Objective: To explore the effect of collagen sponge in preventing postoperative bleeding and incision adhesion after thyroidectomy. Methods: 98 patients with thyroid surgery, from October 2017 to June 2018, were randomly divided into two groups: observation group and control group. In the observation group, after resection of the lesion, the bleeding was completely stopped by ultrasonic scalpel and bipolar electrocoagulation forceps, and collagen sponge was placed between the surgical wound and anterior cervical muscle group. In the control group, collagen sponge was not placed after complete hemostasis with ultrasonic scalpel and bipolar electrocoagulation forceps. The drainage volume of negative pressure drainage tube and the adhesion of incision and blood oozing were observed after operation. Results: The negative pressure drainage volume of the observation group was 14.64±6.18 ml 24 hours after operation, which was lower than that of the control group (36.68±9.28 ml), with difference statistically significant(p<0.05). The negative pressure drainage volume of the observation group was 38.10±7.29ml 48 hours after operation, which was lower than that of the control group (56.12±8.67ml), with difference statistically significant(p<0.05). The incidence of blood seepage was 4.08 % in the post-operative group, which was lower than 16.33 % in the control group. The difference was statistically significant.(p<0.05);The synchronous neck movement rate of the observation group was 10.20%, three months after operation, which was significantly lower than that of the control group (26.53%), with difference statistically significant(p<0.05). Conclusion: The application of collagen sponge in thyroidectomy can effectively prevent postoperative bleeding and incision adhesion, reduce the risk of postoperative bleeding, reduce the incidence of incision adhesion, and has good clinical application value.

关 键 词：甲状腺手术 胶原蛋白海绵 术后出血 切口粘连 

分 类 号：R653[医药卫生—外科学]