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甲状腺手术后血肿再次探查的临床特征及护理策略:来自中国一项7年单中心研究的见解

Clinical features and nursing strategies of reexploration for hematomas after thyroid surgery: insights from a 7-year single-center study in China.

作者信息

Zhang Xiuting, Hu Benling, Zhang Xuesong, Zhang Jingya, Zhu Liqin, Kuang Yanbing, Huang Zhiheng, Weng Yujing

机构信息

The Division of Thyroid Surgery, Department of General Surgery, The University of Hong Kong- Shenzhen Hospital, 1 Haiyuan 1st Road, Shenzhen, Guangdong, People's Republic of China.

出版信息

BMC Surg. 2025 Jun 4;25(1):241. doi: 10.1186/s12893-025-02923-8.

Abstract

OBJECTIVE

To explore clinical characteristics of postoperative hemorrhage following thyroid or parathyroid surgery, and to discuss the nursing strategies for its prevention.

METHODS

A retrospective analysis was conducted on all patients who underwent thyroid or parathyroid surgery from February 2016 to September 2023. The clinical data of patients who experienced postoperative hemorrhage and required reoperation were collected and analyzed.

RESULTS

Among the 5579 patients who underwent surgery, 42 patients experienced postoperative hemorrhage and required reoperation. Hemorrhage occurred within 6 h in 19 cases (45.2%) and within 24 h in 35 cases (83.3%). The most common bleeding sites were the anterior cervical muscle group (44.2%) and branches of the superior or inferior thyroid artery (20.9%). Underlying diseases such as hypertension, diabetes, hemophilia, and postoperative activities like neck movements, coughing, vomiting, and drainage tube manipulation were potential risk factors for postoperative hemorrhage. Clinical manifestations of postoperative hemorrhage included neck swelling or tightness, increased drainage fluid with clots, incision bleeding, pain, skin bruising, and worsening dyspnea.

CONCLUSION

Understanding the potential risk factors and characteristics of postoperative hemorrhage in thyroid surgery is crucial for specialized thyroid nursing care, as it can aid in its prevention and treatment.

摘要

目的

探讨甲状腺或甲状旁腺手术后出血的临床特征,并探讨其预防的护理策略。

方法

对2016年2月至2023年9月期间接受甲状腺或甲状旁腺手术的所有患者进行回顾性分析。收集并分析发生术后出血且需要再次手术的患者的临床资料。

结果

在5579例接受手术的患者中,42例发生术后出血且需要再次手术。19例(45.2%)出血发生在6小时内,35例(83.3%)出血发生在24小时内。最常见的出血部位是颈前肌群(44.2%)和甲状腺上、下动脉分支(20.9%)。高血压、糖尿病、血友病等基础疾病以及颈部活动、咳嗽、呕吐和引流管操作等术后活动是术后出血的潜在危险因素。术后出血的临床表现包括颈部肿胀或紧绷、引流液增多伴血凝块、切口出血、疼痛、皮肤瘀斑和呼吸困难加重。

结论

了解甲状腺手术术后出血的潜在危险因素和特征对于专业的甲状腺护理至关重要,因为这有助于预防和治疗术后出血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc4a/12135240/159991646687/12893_2025_2923_Fig1_HTML.jpg

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