甲状腺术后引流的研究进展

Research Progress of Drainage after Surgery for Thyroid

甲状腺疾病为常见病、多发病,治疗采取以手术为主的综合治疗策略。因积血、积液、血肿等甲状腺术后并发症,可压迫气管导致患者窒息,所以一直备受医学界的重视。甲状腺术后常规放置引流,可以明显降低术后并发症的发生率,故临床于甲状腺术后常规放置引流。然而,术后不予以常规引流,也不会明显增加术后并发症的发生率,反而降低了术后切口感染率、疼痛评分,并缩短了住院时间。目前,甲状腺良性疾病术后,甚至部分甲状腺恶性疾病行颈部淋巴结清扫术后,不建议常规放置引流。随着手术工具的改进和止血技术的进步,甲状腺术后渗血和渗液量明显减少,未来甲状腺术后不予常规引流将逐渐成为共识。

Thyroid disease is a common and frequently-occurring disease, and the treatment is mainly based on the combination of surgical treatment strategy. The complications, such as hemorrhage, effusion and hematoma, may cause the trachea to suffocate. Therefore, this problem has long been attached much importance by the medical community. Considering routine placement of drainage after thyroidectomy can significantly reduce and decrease the incidence of postoperative complications,so the placement of drainage after thyroidectomy is a routine practice in clinical. However,the incidence of complications after operation is not significantly increased when no routine drainage is performed, and the rate of incision infection, pain score and hospitalization time are reduced. Currently, routine thyroidectomy is not recommended for the treatment of benign thyroid diseases, also for partial malignant thyroid disease and neck dissection. With the improvement of surgical tools and the progress of hemostasis techniques, the postoperative bleeding and effusion are significantly decreased, and no routine drainage after thyroidectomy will gradually become a consensus.