甲状腺术后出血50例临床分析  

Clinical analysis and prevention of 50 cases of postoperative thyroid bleeding

作　　者：逯超[1] 李金娇 刘谨文[1] 易继林[1] 郑伟红[1] LU Chao;LI Jinjiao;LIU Jinwen(Departmenu of Thyroid and Breast Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院甲状腺与乳腺外科,武汉430030

出　　处：《临床外科杂志》2020年第8期771-773,共3页Journal of Clinical Surgery

摘　　要：目的分析50例甲状腺手术术后出血病人的临床特征及处理方式。方法2015年1月~2019年11月间收治的甲状腺手术术后出血病人50例,根据术后出血处理方法的不同,分为手术治疗组(29例)和非手术治疗组(21例),比较两组病例临床特征。结果单因素分析结果显示,两组病人性别、出血诱因、甲状腺手术结束至发现出血的时间、出血时的颈部症状比较,差异有统计学意义(P<0.05),多因素分析显示,男性(OR值1.38)、颈部肿胀(OR值2.68)是手术止血的独立影响因素。手术治疗组探查发现,最常见出血部位为颈前静脉及其与颈阔肌皮瓣之间交通支。结论男性和颈部肿胀是甲状腺术后出血需手术治疗的独立影响因素,甲状腺手术关闭切口前应特别注意对颈前静脉及其与颈阔肌皮瓣之间交通支进行检查。Objective To analyze the clinical characteristics and treatment methods of 50 patients with hemorrhage after thyroid surgery,and explore the prevention and treatment of postoperative thyroid bleeding.Methods The clinical data of 50 patients with hemorrhage after thyroid surgery from January 2015 to November 2019 were retrospectively analyzed.These patients were divided into surgical treatment group(29 cases)and non-surgical treatment group(21 cases)according to the treatment for the postoperative bleeding.The clinical characteristics of the two groups were compared.Results The results of univariate analysis showed that gender,cause of bleeding,time from the end of thyroid surgery to the discovery of bleeding,and neck symptoms during bleeding were statistically significant in the two groups of cases(P<0.05).Male(OR value1.38)and Neck swelling(OR value 2.68)was an independent influencing factor for surgical hemostasis.The surgical treatment group found that the most common bleeding site was the anterior jugular vein and its communicating branch with the latissimus dorsi flap.Conclusion Male and neck swelling is an independent influencing factor for surgical hemostasis.Before closing the incision in thyroid surgery,special attention should be paid to the examination of the anterior jugular vein and the branch of communication with the latissimus dorsi flap.

关 键 词：甲状腺术后出血 处理 预防 

分 类 号：R653[医药卫生—外科学]