Hassan-Smith Z K, Gopinath P, Mihaimeed F
Department of Surgery, Newham University Hospital NHS Trust, Glen Road Plaistow, London E13 8SL, UK.
J Thyroid Res. 2011 Feb 10;2011:329620. doi: 10.4061/2011/329620.
Background and Aims. Complications following thyroidectomy can prolong hospital stay and cause significant morbidity particularly for patients treated for benign thyroid conditions. Our aim was to administer a UK-wide survey of thyroid surgery units on frequency and timing of the onset of life-threatening airway complications & correlate to factors that might be associated with them. Methods. A questionnaire including the number of and timing of the onset of life-threatening airway complications, number of thyroidectomy procedures performed per year, surgeon years of experience, the use of difficult airway management protocol, post-operative patient destination, and patient deaths, was sent to 80 UK surgical units. Results. 23/41 hospitals responded reported no postthyroidectomy airway complications. Life-threatening airways complications all occurred within the first 12 hours postoperatively, with 9 cases occurring in the recovery room and in less than 2 hours, 3 cases occurring 2-6 hours, and 3 cases occurring 6 to 12 hours after surgery. Conclusion. The results may support recent publications that advocate thyroidectomy as a less-than-24-hour surgery procedure in selected patients. Further a larger study and standardised protocol are required to establish patients' selection criteria to determine who are likely to develop serious postoperative complication and may require HDU bed.
背景与目的。甲状腺切除术后的并发症会延长住院时间，并导致显著的发病率，尤其是对于接受良性甲状腺疾病治疗的患者。我们的目的是在英国范围内对甲状腺手术科室进行调查，了解危及生命的气道并发症的发生频率和时间，并将其与可能与之相关的因素进行关联。方法。向英国80个手术科室发送了一份问卷，内容包括危及生命的气道并发症的发生数量和时间、每年进行的甲状腺切除手术数量、外科医生的经验年限、困难气道管理方案的使用情况、术后患者的去向以及患者死亡情况。结果。41家医院中有23家回复称未发生甲状腺切除术后气道并发症。危及生命的气道并发症均发生在术后12小时内，其中9例发生在恢复室且在2小时内，3例发生在术后2至6小时，3例发生在术后6至12小时。结论。这些结果可能支持最近的一些出版物，这些出版物主张在特定患者中，甲状腺切除术作为一种手术时间少于24小时的手术。此外，需要进行更大规模的研究和标准化方案，以确定患者的选择标准，从而确定哪些患者可能会发生严重的术后并发症，可能需要重症监护病房床位。
