甲状腺切除术后局部应用氨甲环酸减少引流量的效果观察  

The effect of local application of tranexamic acid on reducing drainage volume after thyroidectomy

作　　者：罗志委 吉鸿利 连金山 陈雅梅 高江 常佳奇 王龙龙[2] Luo Zhiwei;Ji Hongli;Lian Jinshan;Chen Yamei;Gao Jiang;Chang Jiaqi;Wang Longlong(Graduate School of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014060,China;Second Department of Head and Neck,Baotou Cancer Hospital,Baotou 014030,China)

机构地区：[1]内蒙古科技大学包头医学院研究生院,包头014060 [2]包头市肿瘤医院头颈二科,包头014030

出　　处：《中国医师进修杂志》2024年第5期456-460,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨甲状腺切除术后局部喷洒氨甲环酸减少引流量的效果和安全性。方法采用随机双盲安慰剂对照研究方法,选取2022年12月至2023年8月包头市肿瘤医院择期行甲状腺切除术患者64例,按随机数字表法分为氨甲环酸和对照组,每组32例。术中关闭创面前,氨甲环酸组采用25 mg/ml氨甲环酸注射液16 ml冲洗创面,局部喷洒氨甲环酸注射液1 ml(含氨甲环酸100 mg);对照组采用灭菌注射用水16 ml冲洗创面,局部喷洒灭菌注射用水1 ml,随即夹闭引流管20 min。记录术后第1~4天颈部引流量、并发症;术前和术后1 d检测C-反应蛋白水平。结果每组各有2例患者中途退出研究。氨甲环酸组术后第1、2和3天引流量及总引流量明显少于对照组[(29.10±8.04)ml比(38.50±8.67)ml、(18.00±7.33)ml比(27.20±10.66)ml、(10.70±5.75)ml比(14.60±6.83)ml和(69.20±24.48)ml比(96.70±31.90)ml],差异有统计学意义(P<0.01);两组术后第4天引流量比较差异无统计学意义(P>0.05)。两组患者术前和术后C反应蛋白比较差异无统计学意义(P>0.05)。对照组术后出现发热(体温37.5℃)1例;两组均未发生肌间血栓、静脉血栓、切口感染及切口延迟愈合等并发症。结论甲状腺切除术后局部应用氨甲环酸可以减少术后引流量,且并未增加血栓、感染和延迟愈合等相关风险。Objective To explore the effect and safety of local spraying tranexamic acid after thyroidectomy.MethodsRandomized double-blind placebo-controlled study method was used.Sixty-four patients underwent scheduled thyroidectomy from December 2022 to August 2023 in Baotou Cancer Hospital were selected.The patients were divided into tranexamic acid group and control group by random digits table method with 32 cases each.Before closing the wound during surgery,16 ml of tranexamic acid injection with concentration of 25 mg/ml was used to wash the wound and 1 ml of tranexamic acid injection(tranexamic acid 100 mg)used to locally spray in tranexamic acid group;16 ml of the sterile water for injection was used to wash the wound and 1 ml of sterile water for injection was used locally spray in control group,and then the drainage tube was clipped for 20 min.The neck drainage volume on the first to fourth day after surgery and complication were recorded;the C-reactive protein level before and after surgery was detected.ResultsTwo patients in each group withdrew from the study midway.The drainage volume on the first,second and third day and total drainage volume in tranexamic acid group were significantly lower than those in control group:(29.10±8.04)ml vs.(38.50±8.67)ml,(18.00±7.33)ml vs.(27.20±10.66)ml,(10.70±5.75)ml vs.(14.60±6.83)ml and(69.20±24.48)ml vs.(96.70±31.90)ml,and there was statistical difference(P<0.01);there was no statistical difference in the drainage volume on the fourth day after surgery between two groups(P>0.05).There was no statistical difference in C-reactive protein before and after surgery between two groups(P>0.05).There was 1 case of fever(body temperature 37.5℃)in the control group,and there were no complications such as intermuscular thrombosis,venous thrombosis,incision infection and delayed wound healing in both groups.ConclusionsLocal application of tranexamic acid after thyroidectomy can reduce postoperative drainage volume and does not increase the risk of thrombosis,infection and del

关 键 词：甲状腺切除术 氨甲环酸 引流量 局部用药 

分 类 号：R653[医药卫生—外科学]