胸乳入路腔镜甲状腺手术后颈部血清肿危险因素分析  

作　　者：刘铭 张露 黎东伟[1] 余伟儇 李洪[1] 王力斌[1] 刘海平 李伟聪 张运达 

机构地区：[1]广东省东莞东华医院松山湖院区,523808

出　　处：《浙江临床医学》2022年第9期1353-1355,共3页Zhejiang Clinical Medical Journal

基　　金：广东省东莞市社会科技发展(重点项目(202050715046226))。

摘　　要：目的分析胸乳入路腔镜甲状腺手术后血清肿的相关危险因素,探讨预防及减少术后血清肿的措施.方法收集2017年6月至2021年6月行胸乳入路腔镜甲状腺手术1,723例患者的临床资料,包括性别、年龄、甲状腺结节大小、中央区淋巴结清扫、糖尿病、甲状腺功能亢进、手术时间、使用抗血小板药物等.分析引起术后血清肿的相关因素.结果1,723例患者中,发生颈部血清肿36例(2.09%).单因素分析结果显示,与术后颈部血清肿相关因素包括中央区淋巴结清扫、糖尿病、肿瘤大小、手术时间.多因素分析结果显示,中央区淋巴结清扫(OR:2.448,95%CI:1.200~4.996)、糖尿病(OR:7.578,95%CI:2.323~24.722)是胸乳入路腔镜甲状腺术后颈部血清肿发生的独立危险因素.结论胸乳入路腔镜甲状腺手术后颈部血清肿发生率低,中央区淋巴结清扫、糖尿病是发生术后颈部血清肿的高危因素.Objective To analyze the related risk factors of seroma after endoscopic thyroidectomy via a chest-breast approach,and to explore measures to prevent and reduce postoperative seroma.Methods The clinical data of 1,723 patients who underwent endoscopic thyroidectomy via chestbreast approach in general surgery department of Dong-Hua Hospital from June 2017 to June 2021 were retrospectively analyzed.Gender,age,thyroid nodule size,central lymph node dissection,diabetes mellitus,hyperthyroidism,operative time,use of antiplatelet drugs etc.were collected to analyze the relative factors causing postoperative seroma.Results The incidence of postoperative seroma was 2.09%.Univariate analysis showed that factors associated with postoperative neck seroma included central lymph node dissection,diabetes,tumor size and operation time.Mulivariate analysis showed that central lymph node dissection(OR:2.448,95%CI:1.200~4.996)and diabetes(OR:7.578 and 95%CI:2.323~24.722)were independent risk factors for cervical seroma after endoscopic thyroidectomy through the chest-breast approach.ConclusionThere is a low incidence of cervical seroma fter endoscopic thyroidectomy through the chest-breast approach.Patients with central lymph node dissection and diabetes are at high risk of postoperative cervical seroma.

关 键 词：胸乳入路 腔镜甲状腺手术 血清肿 

分 类 号：R653[医药卫生—外科学]