经皮打包缝扎在胸乳入路腔镜甲状腺手术中预防隧道出血的应用

Percutaneous packet-suturing for tunnel bleeding in endoscopic thyroidectomy via thoracic and mammary approach

回顾分析2010年6月至2015年7月192例行胸乳入路腔镜下甲状腺手术治疗患者的临床资料.192例中术中发生隧道出血者11例（出血组）,与未出血组（181例）对比,建立隧道时偏离正确层次者出血的发生率明显升高[3/8与4.3％（8/184）,P＜0.01],术后引流量[（65.4±7.5）与（63.8±7.1）m1]、皮下瘀斑[1/11与1.1％（2/181）]、切口护理费用[（135±20）与（132±16）元]、术后住院时间[（4.5±1.6）与（4.4±1.3）d]、再出血率[0/11与0.6％（1/181）]比较,差异均无统计学意义（均P ＞0.05）.提示经皮打包缝扎止血效果可靠,不增加术后并发症,处理胸乳入路腔镜甲状腺手术中隧道出血较为理想.

The clinical data of 192 patients undergoing endoscopic thyroidectomy via thoracic and mammary approach from June 2010 to July 2015 were retrospectively analyzed.Tunnel bleeding occurred in 11 cases （hemorrhage group）,which was associated with the incorrect level of puncture（P ＜ 0.01）.The tunnel bleeding was stopped by percutaneous packet-suturing in all 11 cases.There were no significant differences in postoperative drainage [（65.4 ± 7.5） and （63.8 ± 7.1） ml],subcutaneous petechiae [1/11 and 1.1％ （2/181）],nursing costs[（135 ±20） and（132 ± 16） yuan],postoperative hospital stay[（4.5 ± 1.6） and （4.4 ± 1.3） d] and rehemorrhage [0/11 and 0.6％ （1/181）] between hemorrhage and nonhemorrhage groups.The results show that percutaneous packet-suturing is reliable and effective method for tunnel bleeding without additional postoperative complications.