Department of Anesthesiology, Cantonal Hospital of Grisons, Löestrasse 170, 7000, Chur, Switzerland.
Indiana University School of Medicine South Bend, Goshen Center for Cancer Care, 200 High Park Ave., Goshen, IN, 46526, USA.
Sci Rep. 2020 Feb 4;10(1):1753. doi: 10.1038/s41598-020-58666-4.
Postoperative bleeding remains one of the most frequent, but rarely life-threatening complications in thyroid surgery. Although arterial bleeding is the main cause of postoperative hemorrhage, most often no actively bleeding vessel can be found during revision. Therefore, the coagulation technique for larger vessels may play a minor role, and hemostatic agents could be of higher importance. In this descriptive, retrospective study, data of 279 patients with thyroid surgery (total of 414 thyroid lobectomies) were collected. We reviewed the electronic medical record by analyzing the histological, operative, laboratory and discharge reports in regards to postoperative bleeding. Of the 414 operated thyroid lobes, 2.4% (n = 10) bled. 1.4% (n = 6) needed reoperation while the other 1.0% (n = 4) could be treated conservatively. Hemostatic patches were applied 286 (69.1%) times. Of the 128 (30.9%) patch-free operated sides, 4.7% (n = 6) suffered postoperative bleeding. Tachosil® alone was used 211 (51.0%) times and bleeding occurred in 1.4% (n = 3). Without statistical significance (p = 0.08) the use of Tachosil® seems to help preventing postoperative bleeding. The combination with other patches doesn't appear to be more efficient.
术后出血仍然是甲状腺手术中最常见但很少危及生命的并发症之一。尽管动脉出血是术后出血的主要原因，但在翻修手术中，大多数情况下都找不到明显的出血血管。因此，较大血管的凝血技术可能作用较小，止血剂可能更为重要。在这项描述性、回顾性研究中，收集了 279 例甲状腺手术患者（共 414 例甲状腺叶切除术）的数据。我们通过分析组织学、手术、实验室和出院报告来回顾电子病历，以了解术后出血情况。在 414 个接受手术的甲状腺叶中，有 2.4%（n=10）发生出血。1.4%（n=6）需要再次手术，而另外 1.0%（n=4）可以保守治疗。止血贴共使用了 286 次（69.1%）。在 128 个未使用止血贴的手术侧中，有 4.7%（n=6）发生术后出血。单独使用泰绫®的次数为 211 次（51.0%），出血发生率为 1.4%（n=3）。虽然没有统计学意义（p=0.08），但使用泰绫®似乎有助于预防术后出血。与其他止血贴联合使用并不更有效。
