甲状腺手术引流方法与切口皮肤疤痕粘连的关系

Relationship Between Variety of Drainge for Thyroidectomy and Scar Adhesion of Wound

目的探讨甲状腺手术引流与切口皮肤疤痕粘连的关系,通过总结临床实践经验,比较各种不同的甲状腺手术引流方法与切口皮肤疤痕粘连的关系,以求找到比较理想的甲状腺手术引流方法,尽量减少切口皮肤疤痕粘连的发生,为今后临床实践中采取何种甲状腺手术引流方法提供理论依据。方法对我院1998～2002年间398例行各种甲状腺手术的患者进行了回顾性分析,并随访满一年,选取甲状腺手术引流方法和切口皮肤疤痕粘连进行统计学分析。结果398例患者中32例发生切口皮肤疤痕粘连,发生率8.0%; 采取从切口正中引出胶管接负压袋引流方法的患者96例,其中15例发生切口皮肤疤痕粘连,发生率15.6%;采取从切口下方皮肤另戳口引出胶管接负压袋引流方法的患者298例,其中17例发生切口皮肤疤痕粘连,发生率5.7%; 采取从切口引出胶片作引流的4例,未见皮肤疤痕粘连。结论采取从切口正中引出胶管接负压袋引流方法发生切口皮肤疤痕粘连的机会较高;采取从切口下方皮肤另戳口引出胶管接负压袋引流方法的机会较低,建议采取后一种甲状腺手术引流方法,以减少切口皮肤疤痕粘连的发生。

Objective To investigate the relationship between variety of drainge for thyroidectomyand scar adhesion of wound, try to find a comparatively perfect drainge for thyroidectomy, to the bestof decreasing the morbility of scar adhesion of wound. Method 398 cases of variety of thyroidectomyin our department from 1998～2002 were studied restospectively and over one year postoperativefollow-up was done.To analyse the relationship betwween variety of drainge for thyroidectomy and scaradhesion of wound with statistics. Result 32 in 398 cases with scar adhesion of wound,the rate of scaradhesion of wound was 8.0%; 15 in 96 cases which the drain tube going out through the median of incisionwith scar adhesion of wound,the rate of scar adhesion of wound was 15.6%;17 in 298 cases which the draintube going out below the incision with scar adhesion of wound, the rate of scar adhesion of wound was5.7%. Conclusion The morbidity of scar adhesion of wound is lower in the patients which drain tubegoing out below the incision than in the patients which drain tube going out through the median ofincision.