文章摘要

甲状腺癌根治术不常规放置颈部引流管的可行性

作者: 1,2樊 伟华, 1鲁 意迅, 1谢 天宇, 3徐 敬周, 1邱 兆岩
1 中国人民解放军总医院普通外科,北京 100853
2 石家庄市藁城人民医院外一科,石家庄 052160
3 安阳市第三人民医院普通外科,河南 安阳 455000
通讯: 邱 兆岩 Email: 301qzy@sina.com
DOI: 10.3978/j.issn.2095-6959.2020.02.021

摘要

目的:评价甲状腺癌根治术不常规放置颈部引流管的可行性及其临床意义。方法:回顾性分析2017年9月至2018年9月我科行择期甲状腺癌根治术314例患者临床资料,其中111例未放置颈部引流管,其余203例放置颈部引流管,比较两组患者基线资料[包括年龄、性别、体重指数(BMI)、手术方式、病理类型、淋巴结转移情况]、术后住院日、术后疼痛评分、术后换药次数及并发症发生率。结果:两组患者在平均年龄、性别构成、BMI指数、手术方式、术后病理分型等方面差异均无统计学意义,无引流组较引流组术后住院日明显缩短[(1.51±0.60) d vs (2.75±0.87) d,P<0.001],术后疼痛明显减轻(VAS评分:2.34±1.12 vs 2.78±1.52,P<0.01],术后换药次数明显减少(1.68±0.81 vs 2.52±1.85,P<0.001),二者在并发症发生率方面差异无统计学意义。结论:甲状腺癌根治术后不放置引流管可加快患者康复,且并不增加并发症发生率,故需严格把握引流管放置指征,不建议常规预防性放置颈部引流管。
关键词: 甲状腺癌根治术;颈部引流;快速康复

Feasibility of neck drainage and no drainage after radical thyroidectomy for thyroid cancer

Authors: 1,2FAN Weihua, 1LU Yixun, 1XIE Tianyu, 3XU Jingzhou, 1QIU Zhaoyan
1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
2 First Department of General Surgery, Gaocheng People’s Hospital, Shijiazhuang 052160, China
3 Department of General Surgery, Anyang Third People’s Hospital, Anyang Henan 455000, China

CorrespondingAuthor:QIU Zhaoyan Email: 301qzy@sina.com

Abstract

Objective: To clarify the value of unconventional prophylactic drain placement in radical thyroidectomy for thyroid cancer. Methods: The subjects of this retrospective study were 314 patients with thyroid cancer who underwent thyroidectomy in our department between September 2017 and September 2018. The patients were divided into two groups according to whether the drain tube was placed in the neck. The drain group comprised 203 patients with routine prophylactic drain placement and the no drain group comprised 111 patients with no drain placement after surgery. General information, post-operative recovery and incidence of post-operative complications were compared between the two groups. Results: There were no significant differences in the general information and postoperative complications in the two groups. The no drain group had shorter hospital stay [(1.51±0.60) d vs (2.75±0.87) d, P<0.001], less pain (VAS score: 2.34±1.12 vs 2.78±1.52, P<0.01] and less times (1.68±0.81 vs 2.52±1.85, P<0.001) of wound dressing change after operation compared with the drain group. Conclusion: The unconventional prophylactic drain placement in rectal thyroidectomy is safe and feasible. Unnecessary drain placement should be avoided.
Keywords: radical thyroidectomy; drainage in neck; quick recovery