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甲状腺手术中术后引流管的常规使用:一个过时的概念。

The routine use of post-operative drains in thyroid surgery: an outdated concept.

作者信息

Prichard R S, Murphy R, Lowry A, McLaughlin R, Malone C, Kerin M J

出版信息

Ir Med J. 2010 Jan;103(1):26-7.

Abstract

The use of surgical drains in patients undergoing thyroid surgery is standard surgical teaching. Life-threatening complications, arising from post-operative haematomas, mandates their utilization. There is increasing evidence to suggest that this is an outdated practice. This paper determines whether thyroid surgery can be safely performed without the routine use of drains. A retrospective review of patients undergoing thyroid surgery, over a three year period was performed and post-operative complications documented. One hundred and four thyroidectomies were performed. 63 (60.6%) patients had a partial thyroidectomy, 27 (25.9%) had a total thyroidectomy and 14 (13.5%) had a sub-total thyroidectomy. Suction drains were not inserted in any patient. A cervical haematoma did not develop in any patient in this series and no patient required re-operation. There is no evidence to suggest the routine use of surgical drains following uncomplicated thyroid surgery reduces the rate of haematoma formation or re-operation rates and indeed is now unwarranted.

摘要

在接受甲状腺手术的患者中使用手术引流管是标准的外科教学内容。术后血肿引发的危及生命的并发症使得必须使用引流管。但越来越多的证据表明这是一种过时的做法。本文旨在确定甲状腺手术在不常规使用引流管的情况下是否能安全进行。对三年内接受甲状腺手术的患者进行了回顾性研究,并记录了术后并发症。共进行了104例甲状腺切除术。63例(60.6%)患者接受了部分甲状腺切除术,27例(25.9%)接受了全甲状腺切除术,14例(13.5%)接受了次全甲状腺切除术。所有患者均未插入吸引引流管。该系列中没有患者发生颈部血肿,也没有患者需要再次手术。没有证据表明在无并发症的甲状腺手术后常规使用手术引流管能降低血肿形成率或再次手术率,实际上现在这种做法已无必要。

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