开放性甲状腺癌手术患者术后出血相关危险因素分析  

Analysis of related risk factors of postoperative hemorrhage in patients undergoing open thyroid cancer operation

作　　者：李鹏 罗瑞华 郭兰伟 李文鹿[3] 齐金星 LI Peng;LUO Ruihua;GUO Lanwei;LI Wenlu;QI Jinxing(Department of Head Neck and Thyroid Surgery,the Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,Henan Province,China;Department of Cancer Control and Research,the Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,Henan Province,China;Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学附属肿瘤医院头颈甲状腺外科,河南郑州450008 [2]郑州大学附属肿瘤医院肿瘤防办中心,河南郑州450008 [3]郑州大学第一附属医院口腔颌面外科,河南郑州450052

出　　处：《新乡医学院学报》2020年第3期274-276,281,共4页Journal of Xinxiang Medical University

基　　金：国家自然科学基金资助项目(编号:81703298,81402578);河南省医学科技攻关计划联合共建项目(编号:2018020488);河南省重点研发与推广专项(科技攻关)(编号:192102310354)。

摘　　要：目的探讨开放性甲状腺癌手术患者术后出血的相关影响因素,为预防出血导致严重并发症提供参考依据。方法回顾性分析2014年5月至2019年5月于郑州大学附属肿瘤医院行开放性甲状腺癌手术的2871例患者的临床资料,采用单因素和多因素logistic回归分析开放性甲状腺癌手术后发生出血的相关危险因素。结果2871例行开放性甲状腺癌手术患者中,术后出血41例,术后出血率为1.43%(41/2871)。开放性甲状腺癌手术后出血与手术时间、术中出血量、合并全身系统性疾病(糖尿病、高血压及冠状动脉粥样硬化性心脏病)及合并甲状腺自身免疫性疾病(桥本甲状腺炎、甲状腺功能亢进)有关(P<0.05),与患者年龄、性别、病理类型、T分期、N分期及临床分期无关(P>0.05)。多因素logistic回归分析结果显示,手术时间、术中出血量、颈淋巴结清扫、合并全身系统性疾病(糖尿病、高血压及冠状动脉粥样硬化性心脏)及合并甲状腺自身免疫性疾病(桥本甲状腺炎、甲状腺功能亢进症)是影响甲状腺癌术后出血的相关因素(P<0.05)。结论手术时间、术中出血量、颈淋巴结清扫、合并全身系统性疾病(糖尿病、高血压及冠状动脉粥样硬化性心脏病)及合并甲状腺自身免疫性疾病(桥本甲状腺炎、甲状腺功能亢进症)是影响甲状腺癌术后出血的危险因素。Objective To analysis the related risk factors of postoperative hemorrhage in patients undergoing open thyroid cancer operation and to provide reference for preventing the serious complications caused by hemorrhage.Methods The data of 2871 patients undergoing open thyroid cancer operation in the Affiliated Cancer Hospital of Zhengzhou University from May 2014 to May 2019 were analyzed respectively.Univariate logistic regression and multivariate logistic regression were used to analyze the risk factors of hemorrhage after open thyroid cancer operation.Results A total of 41 cases among 2871 patients had postoperative hemorrhage and the hemorrhage rate was 1.43%.Hemorrhage in the patients undergoing open thyroid cancer operation was related to operation time,intraoperative bleeding volume,neck lymph node dissection,systemic diseases(diabetes,hypertension and coronary heart disease)and autoimmune thyroid diseases(hashimoto thyroiditis and hyperthyroidism)(P<0.05),but it was not related to age,gender,pathological type,T stage,N stage and clinical stage(P>0.05).Multivariate logistic regression analysis showed that operation time,intraoperative bleeding volume,neck lymph node dissection,systemic diseases(diabetes,hypertension and coronary heart disease)and autoimmune thyroid diseases(hashimoto thyroiditis and hyperthyroidism)are the related factors affecting postoperative hemorrhage of thyroid cancer.Conclusion The operation time,intraoperative bleeding volume,neck lymph node dissection,systemic diseases(diabetes,hypertension and coronary heart disease)and autoimmune thyroid diseases(hashimoto thyroiditis and hyperthyroidism)are the risk factors affecting postoperative hemorrhage of thyroid cancer.

关 键 词：甲状腺癌 甲状腺切除术 术后出血 危险因素 

分 类 号：R736.1[医药卫生—肿瘤]