CAJ | 학술논문

目的开展前瞻随机对照临床试验评估良性甲状腺疾病术后是否需常规放置引流.方法将272例良性甲状腺疾病患者按随机数字表分为引流组(136例)和非引流组(136例),记录两组手术时间和术后住院日,并于术后当天和术后第一天通过可视化模拟量表(visual analogue scale,VAS)评估术后疼痛情况,同时比较两组术后出血、血肿、皮下积液、切口感染、声音嘶哑和暂时性甲状旁腺功能减退等并发症的发生率.结果两组患者在年龄、性别、手术方式等方面均衡,具有可比性.引流组和非引流组患者平均手术时间相近,分别为(87.5±32.0) min和(93.8±30.1)min(t =0.12,P =0.45),但非引流组较引流组明显缩短了术后住院日,分别为(2.6±0.6)d和(1.9±0.3)d(t=1.45,P=0.02),增加了颈部舒适度,术后当天和术后第一天的VAS评分比较,差异有统计学意义(t值分别为2.67,0.33,P值分别为0.03,0.006).两组均未发生需紧急二次手术处理的术后大出血或血肿,无永久性声嘶和永久性甲状旁腺功能减退,其余术后各类并发症发生率两组之间差异均无统计学意义.结论良性甲状腺疾病术后不置引流并不增加术后并发症发生率,而且不置引流可以增加患者舒适度,减轻术后疼痛,减少住院日.因此,良性甲状腺术后没有必要常规放置引流.
목적 개전전첨수궤대조림상시험평고량성갑상선질병술후시부수상규방치인류.방법 장272례량성갑상선질병환자안수궤수자표분위인류조(136례)화비인류조(136례),기록량조수술시간화술후주원일,병우술후당천화술후제일천통과가시화모의량표(visual analogue scale,VAS)평고술후동통정황,동시비교량조술후출혈、혈종、피하적액、절구감염、성음시아화잠시성갑상방선공능감퇴등병발증적발생솔.결과 량조환자재년령、성별、수술방식등방면균형,구유가비성.인류조화비인류조환자평균수술시간상근,분별위(87.5±32.0) min화(93.8±30.1)min(t =0.12,P =0.45),단비인류조교인류조명현축단료술후주원일,분별위(2.6±0.6)d화(1.9±0.3)d(t=1.45,P=0.02),증가료경부서괄도,술후당천화술후제일천적VAS평분비교,차이유통계학의의(t치분별위2.67,0.33,P치분별위0.03,0.006).량조균미발생수긴급이차수술처리적술후대출혈혹혈종,무영구성성시화영구성갑상방선공능감퇴,기여술후각류병발증발생솔량조지간차이균무통계학의의.결론 량성갑상선질병술후불치인류병불증가술후병발증발생솔,이차불치인류가이증가환자서괄도,감경술후동통,감소주원일.인차,량성갑상선술후몰유필요상규방치인류.
Objective To evaluate the necessity of drainage after thyroidectomy for benign thyroid disorders.Methods A total of 272 patients who underwent thyroidectomy for benign thyroid disorders were randomly divided into drainage group or non-drainage group.Operating time,postoperative stay time in hospital,comfort of neck assessed by visual analogue scale (VAS) on postoperative day (POD) 0 and PODI were and the incidence of complications,including post-thyroidectomy bleeding,hematoma,seroma,wound infection,hoarseness,and hypoparathyroidism,were assessed and compared between two groups.Results Both groups were similar in the mean age,the sex ratio and the underwent procedure types.There was no significant difference in the mean operating time between two groups (87.5 ± 32.0) min and (93.8 ± 30.1) min (t =0.12,P =0.45).The mean postoperative hospital stay time of non-drainage group (1.9 ± 0.3) d was significantly shorter than that of drainage group (2.6 ± 0.6) d (t =1.45,P =0.02).The mean VAS scores of neck comfort on POD0 and POD1 in non-drainage group were significantly high than those in nondrainage group (t =2.67,P =0.03 and t =0.33,P =0.006).There were no significant difference in postoperative complications,including permanent hoarseness and hypoparathyroidism,between two groups.Conclusions No drainage after thyroidectomy for benign thyroid disorders does not increase postoperative complications,with the increase in postoperative neck comfort,the decrease in hospital stay time and potential wound infections.The routine drainage is not necessary after thyroid surgery for benign disorders.