甲状腺癌术后不同时间拔除引流条的效果分析
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摘要
目的探讨甲状腺癌术后不同时间拔除引流条的疗效。方法收集我院80例甲状腺癌手术患者临床资料,术后24 h内拔除引流条40例设为A组,术后24～48 h拔除引流条40例设为B组。比较两组患者手术资料(术中出血量、手术时间、淋巴结转移数)、换药次数、术后48 h平均体温、敷料渗液浑浊率、切口感染率、皮下积液率及手术至出院时间。结果两组患者年龄、性别、手术时间、出血量、淋巴结转移情况比较,差异无统计学意义(P>0.05);B组换药次数为(3.45±0.64)次,较A组(2.10±0.50)次增加,B组患者术后48 h内平均体温为(37.54±0.73)℃,较A组(37.08±0.46)℃升高;B组敷料渗液浑浊率(30.00%)及切口感染率(12.50%)也较A组的(10.00%)、0增加,差异具有统计学意义(P<0.05),而皮下积液率及手术至出院时间比较,差异无统计学意义(P>0.05)。结论甲状腺癌术后早期拔除引流条安全、有效。
Objective To investigate the efficacy of removal of drainage strips at different times after thyroid cancer surgery. Methods The clinical data of 80 patients with thyroid cancer surgery were collected. 40 patients with drainage strips were set in group A within 24 h after operation, and 40 patients with drainage strips were set to group B at 24 to 48 h after operation. The surgical data(intraoperative blood loss, operation time, lymph node metastasis), the number of dressing changes, the average body temperature at 48 h after surgery, the turbidity rate of the exudate, the infection rate of the incision, the rate of subcutaneous fluid accumulation, and the time from surgery to discharge were compared between the two groups. Results There were no significant differences in age, gender, operation time, blood loss and lymph node metastasis between the two groups( P >0.05). The number of dressing changes in group B was(3.45±0.64) times, compared with group A(2.10±0.50). The mean increase in body temperature in group B was(37.54±0.73) °C within 48 hours after operation, which was higher than that in group A(37.08 ±0.46) °C;the turbidity rate of exudate in group B(30.00%) and infection rate of incision( 12.50%) also had a statistically significant difference( P<0.05) compared with group A(10.00%) and 0. There was no significant difference in the rate of subcutaneous fluid accumulation and surgery-to-discharge time( P >0.05). Conclusion It is safe and effective to remove the drainage strips early after thyroid cancer surgery.
Objective To investigate the efficacy of removal of drainage strips at different times after thyroid cancer surgery. Methods The clinical data of 80 patients with thyroid cancer surgery were collected. 40 patients with drainage strips were set in group A within 24 h after operation, and 40 patients with drainage strips were set to group B at 24 to 48 h after operation. The surgical data(intraoperative blood loss, operation time, lymph node metastasis), the number of dressing changes, the average body temperature at 48 h after surgery, the turbidity rate of the exudate, the infection rate of the incision, the rate of subcutaneous fluid accumulation, and the time from surgery to discharge were compared between the two groups. Results There were no significant differences in age, gender, operation time, blood loss and lymph node metastasis between the two groups( P >0.05). The number of dressing changes in group B was(3.45±0.64) times, compared with group A(2.10±0.50). The mean increase in body temperature in group B was(37.54±0.73) °C within 48 hours after operation, which was higher than that in group A(37.08 ±0.46) °C;the turbidity rate of exudate in group B(30.00%) and infection rate of incision( 12.50%) also had a statistically significant difference( P<0.05) compared with group A(10.00%) and 0. There was no significant difference in the rate of subcutaneous fluid accumulation and surgery-to-discharge time( P >0.05). Conclusion It is safe and effective to remove the drainage strips early after thyroid cancer surgery.
引文
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[10]Oltmann SC,Alhefdhi AY,Rajaei MH,et al.Antiplatelet and Anticoagulant Medications Significantly Increase the Risk ofPostoperative Hematoma:Review of over 4500 Thyroid andParathyroid Procedures[J].Ann Surg Oncol,2016,23(9):2874-2882.
[11]章琛.甲状腺癌术后并发症的观察及护理[J].医学信息,2016,29(30):186-186.
[12]李小平,黄彧禾,路广.甲状腺术后引流方法的改进[J].实用医学杂志,2012,28(5):847.
[2]Wang S,Liang J,Lin Y,et al.Differential expression of the Na+/I-symporter protein in thyroid cancer and adjacent normal andnodular goiter tissues[J].Oncol Lett,2013,5(1):368.
[3]刘大响,王令焕,徐梅,等.一次性高负压引流瓶在甲状腺癌术后的应用效果及护理措施[J].重庆医学,2018,47(2):283-284.
[4]陈治龙,陈丽华.三种内径引流管用于老年甲状腺次全切除术后引流的疗效[J].中国老年学杂志,2014,10(20):5878-5879.
[5]周亚雄,刘海鹏,祝占奎,等.甲状腺术后引流的研究进展[J].医学综述,2017,23(16):3256-3260.
[6]狄建新,闫荣业.康派特医用胶在甲状腺手术中的应用[J].医学信息,2015,27(12):217.
[7]Liu JH,Sun W,Dong WW,et al.Risk factors for post-thy-roidectomy haemorrhage:a meta-analysis[J].European Journal ofEndocrinology,2017,176(5):591-602.
[8]Narayanan S,Arumugam D,Mennona S,et al.An Evaluation of Postoperative Complications and Cost After Short-Stay ThyroidOperations[J].Ann Surg Oncol,2015,23(5):1440-1445.
[9]Promberger R,Ott J,Kober F,et al.Risk factors for postoperative bleeding after thyroid surgery[J].Br J Surg,2012,99(3):373-379.
[10]Oltmann SC,Alhefdhi AY,Rajaei MH,et al.Antiplatelet and Anticoagulant Medications Significantly Increase the Risk ofPostoperative Hematoma:Review of over 4500 Thyroid andParathyroid Procedures[J].Ann Surg Oncol,2016,23(9):2874-2882.
[11]章琛.甲状腺癌术后并发症的观察及护理[J].医学信息,2016,29(30):186-186.
[12]李小平,黄彧禾,路广.甲状腺术后引流方法的改进[J].实用医学杂志,2012,28(5):847.