摘要
目的 分析甲状腺术后出血的临床特点及预防、治疗策略。方法 回顾性分析2316例开放性甲状腺手术患者的临床资料,研究其中7例甲状腺术后出血患者的临床特点和诊治经过,如症状、体征、甲状腺术后出血时间、甲状腺窝引流量、出血部位等,总结甲状腺术后出血的治疗及预防措施。结果 肥胖、合并甲状腺病理因素、术后咳嗽/恶心呕吐、高血压等为甲状腺术后出血的潜在危险因素。7例甲状腺术后出血患者术后出血时间多集中在术后6 h内,但也有发生在术后24 h以后的迟发性出血。术后出血部位最常见于甲状腺上动脉分支。7例甲状腺术后出血患者均及时果断二次手术探查止血后均未再次发生出血, 3~5 d后康复出院。结论 甲状腺术后需对患者进行密切观察,特别注意患者颈部有无肿胀及引流情况,诊断术后出血时评估患者气道情况,及时果断打开伤口、清除血肿、解除气道压迫是术后出血的治疗原则,而预防更是关键。
Objective To analyze the clinical characteristics, prevention and treatment strategy of hemorrhage after surgery for thyroid gland. Methods The clinical data of 2316 patients with open thyroid surgery were analyzed retrospectively, and the clinical characteristics, diagnosis and treatment of 7 patients with postoperative hemorrhage were analyzed, including symptoms, signs, time of postoperative hemorrhage, drainage volume of thyroid fossa and bleeding site, and the treatment and prevention measures of postoperative hemorrhage were summarized. Results Obesity, combined thyroid pathology, postoperative cough/nausea and vomiting, and hypertension were potential risk factors for postoperative hemorrhage. The postoperative bleeding time of 7 patients was mostly within 6 h after surgery, but there were also delayed bleeding after 24 h after surgery. The most common site of postoperative hemorrhage was the branch of superior thyroid artery. All the 7 patients had timely and decisive secondary surgical explorationand hemostasis, and they recovered and were discharged after 3-5 d without recurrence of hemorrhage. Conclusion Patients need to be closely observed after thyroid surgery, paying special attention to the presence or absence of swelling and drainage in the patient’s neck. When diagnosing postoperative hemorrhage, assessing the patient’s airway, timely and decisively opening the wound, removing the hematoma, and releasing airway compression are the principles for the treatment of postoperative hemorrhage, and prevention is even more critical.
作者
周榆腾
黄亚兰
林鸿国
黄学阳
蔡炳勤
ZHOU Yu-teng;HUANG Ya-lan;LIN Hong-guo(Thyroid Diagnosis and Treatment Center,Guangdong Hospital of Traditional Chinese Medicine,Second Clinical School of Guangzhou University of Chinese Medicine,Guangzhou 510000,China)
出处
《中国现代药物应用》
2022年第10期72-75,共4页
Chinese Journal of Modern Drug Application
基金
国家中医药管理局科研项目(项目编号:12BMGG02)。
关键词
甲状腺术后出血
手术并发症
预防和治疗
Hemorrhage after surgery for thyroid gland
Surgical complications
Prevention and treatment
