摘要
目的探讨甲状腺术后出现危及生命的窒息性血肿的危险因素,为临床工作提供参考。方法通过病历检索系统,筛选出甲状腺术后出血导致危及生命的窒息性血肿患者14例(出血组),同时在该病历系统中按照手术时期、手术医生、麻醉方式等限定条件以1∶2的比例进行配对,选择未出血的甲状腺手术患者28例(对照组)。比较2组患者的基本资料及相关指标,应用多因素Logistic回归分析确定甲状腺术后出血导致危及生命的窒息性血肿的危险因素。结果出血组接受甲状腺全切术比例低于对照组,病理类型中乳头状癌比例低于对照组,术后住院时间长于对照组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,手术方式是甲状腺术后出血导致气道梗阻的危险因素,接受甲状腺部分切除术发生该并发症的风险是接受甲状腺全切术的9.116倍。结论甲状腺部分切除术是甲状腺术后出现窒息性血肿的独立危险因素。
Objective To investigate the risk factors of life-threatening asphyxia hematoma after thyroid surgery,and to provide reference for clinical work.Methods A total of 14 patients(bleeding group)with life-threatening asphyxiated hematoma caused by postoperative thyroid hemorrhage were screened by the case retrieval system.At the same time,according to the operating period,surgeon,anesthesia,etc.,the condition was 1∶2.The proportions were matched and 28 patients with thyroid surgery without bleeding were selected(control group).The basic data and related indicators of the two groups of patients were compared,and multivariate logistic regression analysis was used to determine the risk factors of life-threatening asphyxia hematoma caused by postoperative thyroid hemorrhage.Results The proportion of total thyroidectomy in the bleeding group was lower than that in the control group.The proportion of papillary carcinoma in the pathological type was lower than that in the control group.The postoperative hospital stay was longer than the control group,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that the surgical procedure was a risk factor for airway obstruction caused by postoperative thyroidectomy.The risk of this complication after partial thyroidectomy was 9.116 times that of total thyroidectomy.Conclusion Partial thyroidectomy is an independent risk factor for hemorrhagic hematoma after thyroid surgery.
作者
邹月
虞雪融
ZOU Yue;YU Xue-rong(Depertment of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Depertment of Anesthesiology,Affiliated Beijing Luhe Hospital of Capital Medical University,Beijing 101149,China)
出处
《河北医科大学学报》
CAS
2019年第9期1055-1057,1062,共4页
Journal of Hebei Medical University
关键词
甲状腺疾病
手术后出血
窒息
血肿
thyroid diseases
postoperative hemorrhage
asphyxia
hematoma
