甲状腺术后切口感染的临床分析

Clinical analysis of the incision infections after thyroid operation

目的对甲状腺术后切口感染进行临床分析。方法对1980年1月至2011年12月间在瑞金医院远洋分院外科治疗的17例甲状腺术后切口感染的病人进行回顾性分析。结果 17例病人术后均出现发热和切口的红、肿、热、痛及波动感;查血常规白细胞和中性粒细胞均升高;脓液培养4例为金黄色葡萄球菌感染,5例为表皮葡萄球菌感染,4例为化脓性链球菌感染,4例为阴性;换药后感染伤口均达到Ⅲ/甲愈合,但6例愈合时间超过14 d者颈部留下明显瘢痕。结论甲状腺术中同时切除淋巴结结核、气管误切开后创面使用即溶性止血纱布、甲状腺术后出血再次手术时未彻底消毒和清除血肿及多汗的糖尿病病人术后引流管放置时间过长致伤口未及时闭合是引起甲状腺术后切口感染的原因。

Objective To analyze the incision infections after thyroid operation.Methods The clinical data of 17 cases of the incision infections after thyroid operation from January 1980 to December 2011 at Yuanyang Hospital of Shanghai Jiaotong University School of Medicine were analyzed rstrospectively.Results There were fever and red, swollen,hot,painful and fluctuation of the incision in all patients.Leucocyte and neutrophil were elevated in all patients. With the pus Germicultures,there were staphylococcus albus infection in 4 patients and staphylococcus epidermidis infection in 5 patients and streptococcus pyogenes infection in 4 patients and none infection in 4 patients.With changing their dressing,all wound healed but obvious scars were left in 6 patient whose wound healing time were longer than 14 days.Conclusion The incision infections after thyroid were relative to cutting scrofula away during thyroidectomy and incising the trachea wrongly and sterilizing or eliminating edema un-thoroughly in thyroid bleeding operation and putting drainage tube for long time in hyperhidrosis diabetes patient.