甲状腺叶切除术后手术引流液量增加的预测因素：一项回顾性研究

Predictive factors of increased surgical drain output after thyroid lobectomy: a retrospective study.

作者信息

Chen Chih-Yu, Chiu Yu-Lung, Rajbhandari Sarina, Cheng Sheng-Yao, Lin Hung-Che, Chu Yueng-Hsiang, Lee Jih-Chin

机构信息

Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei.

School of Public Health, National Defense Medical Center, Taipei.

出版信息

Gland Surg. 2019 Oct;8(5):542-549. doi: 10.21037/gs.2019.10.05.

DOI:10.21037/gs.2019.10.05

PMID:31741885

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6842764/

Abstract

BACKGROUND

Thyroid lobectomy is one of the most common operations for thyroid lesions. Life-threatening complications can occur; these include post-operative bleeding with airway compression caused by hematoma. Given this risk, prophylactic drains are routinely used in our practice. The aim of this study was to identify factors that influence the total drainage volume (TDV).

METHODS

From 2016 to 2017, a total of 89 consecutive patients with thyroid lobectomy performed by the same surgeon were included in the study. The demographic characteristics of the patients, TDV, fine needle aspiration cytology, hospitalization day, operation time, thyroid gland size, and blood test results were retrospectively recorded from the hospital database. Spearman's rank correlation and multivariate regression were used to analyze the association of factors with the TDV.

RESULTS

The median TDV was 56 mL, and there was a positive correlation between age, weight, blood sugar, gland size, hospitalization day, operation time, and TDV. Multivariate regression analysis revealed that male sex (β=19.684; 95% CI, 7.998-31.371; P=0.001), higher blood sugar (β=0.173; 95% CI, 0.087-0.260; P<0.001), and larger thyroid gland size (β=0.069; 95% CI, 0.008-0.130; P=0.027) were independent risk factors for TDV.

CONCLUSIONS

The TDV primarily depends on male sex, larger thyroid gland, and higher blood sugar level. Patients with these factors should undergo meticulous hemostasis and bleeding should be carefully monitored in the perioperative period.

摘要

背景

甲状腺叶切除术是治疗甲状腺病变最常见的手术之一。可能会发生危及生命的并发症，包括术后出血伴血肿引起的气道压迫。鉴于此风险，我们在实践中常规使用预防性引流管。本研究的目的是确定影响总引流量（TDV）的因素。

方法

2016年至2017年，共有89例由同一位外科医生进行甲状腺叶切除术的连续患者纳入本研究。从医院数据库中回顾性记录患者的人口统计学特征、TDV、细针穿刺细胞学检查、住院天数、手术时间、甲状腺大小和血液检查结果。采用Spearman等级相关性分析和多因素回归分析来分析各因素与TDV的相关性。

结果

TDV的中位数为56 mL，年龄、体重、血糖、腺体大小、住院天数、手术时间与TDV之间呈正相关。多因素回归分析显示，男性（β=19.684；95%CI，7.998-31.371；P=0.001）、较高的血糖水平（β=0.173；95%CI，0.087-0.260；P<0.001）和较大的甲状腺大小（β=0.069；95%CI，0.008-0.130；P=0.027）是TDV的独立危险因素。