甲状腺乳头状癌甲状腺全切颈侧区淋巴结清扫术中铜绿假单胞菌注射液喷洒预防术后淋巴漏的临床研究  

Clinical study on the prevention of postoperative lymphatic leakage by spraying Pseudomonas aerugnosa injection during total thyroidectomy and cervical lateral lymph node dissection for papillary thyroid carcinoma

作　　者：尚朝阳 贺奇 杜军威[1] 邱新光[1] Shang Zhaoyang;He Qi;Du Junwei;Qiu Xinguang(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院甲状腺外科,郑州450052

出　　处：《河南外科学杂志》2021年第6期27-30,共4页Henan Journal of Surgery

基　　金：河南省科技攻关项目(212102310172)。

摘　　要：目的探讨铜绿假单胞菌注射液在甲状腺乳头状癌(PTC)甲状腺全切颈侧区淋巴结清扫术中应用预防术后淋巴漏的效果。方法前瞻性纳入2019-05—2019-09于郑州大学第一附属医院甲状腺外科行甲状腺全切、中央区和颈侧区淋巴结清扫术的患者。观察组于手术完成后创面喷洒铜绿假单胞菌注射液,对照组喷洒生理盐水。比较2组患者的临床资料和术后体温、引流量、淋巴漏发生率、拔管时间、住院时间。结果共纳入80例患者,每组40例。2组患者的临床资料和术后体温差异无统计学意义(P>0.05)。观察组患者术后12 h、第1天、第2天及总引流量均少于对照组,淋巴漏发生率低于对照组,拔管时间及住院时间短于对照组,差异均有统计学意义(P<0.05)。结论 PTC甲状腺全切、中央区和颈侧区淋巴结清扫术中应用铜绿假单胞菌注射液喷洒创面,可产生无菌性炎症,有利于缩短引流时间和住院时间,降低术后淋巴漏的发生率。但仍需更大样本前瞻性随机对照研究(RCT)予以证实。Objective To investigate the application effect of Pseudomonas aeruginosa injection in lymph node dissection in the cervical lateral area of thyroid cancer.Methods The clinical data of 80 patients with papillary thyroid carcinoma and cervical lymphadenopathy treated in the Thyroid Surgery Department of the First Affiliated Hospital of Zhengzhou University from May 2019 to September 2019 were prospectively included.They were randomly divided into observation group(n=40)and the control group(n=40).The observation group was given Pseudomonas aeruginosa injection,and the control group was given normal saline.Postoperative body temperature,drainage,extubation time,hospital stay,and incidence of lymphatic leakage were recorded and compared between the two groups.Results The observation group 12 h after surgery,the first day after surgery,the second day after surgery and total drainage were significantly reduced compared with that of the control group,the average extubation time and hospital stay in the observation group were shorter than that of the control group,the incidence of postoperative lymphatic leakage in the observation group was lower than that of the control group,the differences were statistically significant(All P<0.05).Conclusion The application of Pseudomonas aeruginosa injection during neck lymph node dissection in patients with papillary thyroid carcinoma can produce aseptic inflammation,reduce wound exudation and postoperative drainage,shorten drainage time,and reduce the incidence of postoperative lymphatic leakage.

关 键 词：甲状腺乳头状癌 颈侧区淋巴结清扫术 铜绿假单胞菌注射液 

分 类 号：R653[医药卫生—外科学]