甲状腺术后时间引流量观察及临床意义

Observations of drainage quality and volume after thyroidectomy and their clinical significance

目的提出并运用甲状腺术后时间引流量概念,探讨甲状腺术后引流管的安全拔除时间。方法对66例各种甲状腺患者术后每4小时记录一次引流液量并送检验科按血常规及积液常规各检查一次。观察各时间段引流液多少、引流液质量、术后疼痛、术后积液、局部粘连情况。结果术后8h内引流液以渗血为主,8h后以渗液为主。每4小时的时间引流量<5ml时拔除引流管是安全的,平均拔管时间19h,无一例出现创腔积血或积液。结论将甲状腺术后时间引流量引入临床后,拔管时间提前24h以上,患者的疼痛减轻,局部粘连减少,心理压力减轻。

Objective To investigate the minimum time after thyroidectomy that a drainage pipe can be safely removed. Especially light up the concept that monitoring time unit drainage after thyroidectomy. Methods The volume of the drainage obtained from 66 patients with various hypothyroid diseases was collected and recorded every 4 hours after thyroidectomy, then it was made a sample. All the samples were sent to a clinical laboratory for analysis（blood routine and fluid routine）. The time unit drainage, the quality of the fluid, the painage rates of the patients after thyroidectomy, the fluid left after a drainage pipe was removed and the appearance of partial eonglutination were observed. Results 8 hours after operation,the drainage was composed primarily of blood and. After an additional 8 hours,it was composed primarily of tissue fluid. Findings indicated that it was safe to withdraw the drainage pipe when the volume of drainage was less than 5ml per 4 hours. This occurred an average of 19 hours post-operative, at which time no blood or tissue fluid was found. Conclusion Once time unit drainage monitoring after thyroidectomy has been introduced to the clinic, it will be possible to safely remove drainage pipes at least 24 hours earlier than in current clinical treatment protocols. Furthermore, pain and anxiety experienced by thyroidectomy patients can be reduced,as well as the appearance of partial conglutination.