甲状腺术后发生咽部癔球症的危险因素分析  

Analysis of risk factors for globus sensation after thyroid surgery

作　　者：何倩 沈安妮 HE Qian;SHEN Anni(Department of Nursing,the Second Affiliated Hospital,School of Medicine of Zhejiang University,Hangzhou,Zhejiang 320000,China)

机构地区：[1]浙江大学医学院附属第二医院护理部,浙江杭州320000

出　　处：《现代医药卫生》2024年第24期4234-4237,4242,共5页Journal of Modern Medicine & Health

摘　　要：目的评估甲状腺术后咽部癔球症的发病率和危险因素,并制定合理的护理对策。方法选取2022年8月至2023年8月该院收治的84例行甲状腺手术患者,收集患者入院时的临床及手术相关参数。运用“甲状腺切除术有关的语音调查问卷”分别在术前及术后1个月进行咽部癔球症评估。根据对问卷中问题12的回答,将患者分为癔球症组(≥1分)和对照组(0分)。采用logistic回归模型分析发生咽部癔球症的危险因素。结果纳入患者中癔球症组36例,对照组48例。癔球症组的女性患者显著多于男性(91.7%vs.54.2%),且中央淋巴结转移及行中央颈淋巴清扫的比例均显著高于对照组,差异均有统计学意义(P<0.001及P=0.032、0.037)。癔球症组患者术后问卷评分较对照组显著升高,差异有统计学意义(P<0.001)。多因素分析结果显示,性别[比值比(OR)=2.135,95%可信区间(95%CI)1.749~2.521,P<0.001]、淋巴结侵犯部位(OR=1.282,95%CI 1.021~1.543,P<0.001)、中央颈淋巴清扫(OR=1.575,95%CI 1.239~1.910,P<0.001)为甲状腺术后发生咽部癔球症的独立危险因素。结论女性患者、中央颈淋巴结清扫和中央淋巴结转移是甲状腺切除术后发生癔球症的独立危险因素。在护理工作中需加强这类患者的心理护理和沟通交流。Objective To assess the incidence and risk factors of globus sensation after thyroid surgery and to develop reasonable nursing strategies.Methods A total of 84 patients who underwent thyroid surgery in our hospital from August 2022 to August 2023 were selected,and clinical and surgical-related parameters were collected upon admission.The“Voice-Related Quality of Life(V-RQOL)Survey for Thyroidectomy”was used to assess globus sensation before surgery and one month after surgery.Based on the responses to question 12 of the survey,patients were divided into a globus sensation group(≥1 point)and a control group(0 point).Logistic regression models were used to analyze the risk factors for globus sensation.Results Among the included patients,36 were in the globus sensation group and 48 in the control group.The globus sensation group had significantly more female patients than male patients(91.7%vs.54.2%),and the proportions of central lymph node metastasis and central neck dissection were significantly higher than those in the control group,with statistically significant differences(P<0.001,P=0.032,and P=0.037,respectively).The postoperative survey scores were significantly higher in the globus sensation group than in the control group,with a statistically significant difference(P<0.001).Multivariate analysis showed that sex[odds ratio(OR)=2.135,95%confidence interval(95%CI)1.749-2.521,P<0.001],location of lymph node invasion(OR=1.282,95%CI 1.021-1.543,P<0.001),and central neck dissection(OR=1.575,95%CI 1.239-1.910,P<0.001)were independent risk factors for globus sensation after thyroid surgery.Conclusion Female patients,central neck dissection,and central lymph node metastasis are independent risk factors for globus sensation after thyroidectomy.In nursing practice,psychological care and communication with these patients should be strengthened.

关 键 词：甲状腺切除术后 癔球症 危险因素 

分 类 号：R450[医药卫生—治疗学]