【摘要】 目的比较两种止血材料在甲状腺乳头状癌患者根治术中应用效果及对引流液甲状旁腺激素(PTH)水平的影响。方法选取单侧甲状腺乳头状癌患者82例,按照术中使用止血材料不同分为止血纱组(n=29)、止血膜组(n=27)和对照组(n=26)。止血纱组术中使用可吸收止血纱(速即纱),止血膜组术中使用可吸收止血膜(止血膜),对照组术中不使用止血材料。统计并比较三组患者术后并发症、住院费用、住院天数、术后引流液PTH、术后引流液量及引流管拔出时间(拔管时间)。结果三组患者手术时间、术中出血量、住院时间和住院费比较,差异无统计学意义(P>0.05);止血纱组和止血膜组术后24h、48h引流液量低于对照组(P<0.05),其中止血纱组术后24h引流液低于止血膜组(P<0.05),止血纱组和止血膜组48 h引流液量比较,差异无统计学意义(t=1.31,P>0.05)。止血纱组和止血膜组拔管时间短于对照组(P<0.05),而止血纱组与止血膜组组间比较,差异无统计学意义(t=0.34,P>0.05);术后第1 d止血纱组、止血膜组和对照组引流液PTH水平比较,差异无统计学意义(P>0.05);术后第2 d止血纱组引流液PTH低于止血膜组和对照组(P<0.05),但止血膜组与对照组比较,差异无统计学意义(t=1.10,P>0.05);三组术后并发症发生率比较,差异无统计学意义(χ2=0.78,P<0.05)。结论甲状腺乳头状癌术中使用止血纱或止血膜,均可有效减少术后渗出,缩短术后拔管时间,不增加术后并发症和住院费用;可吸收止血纱较止血膜具有早期减少渗出的作用,并可能对甲状旁腺功能早期恢复有帮助。更多还原

【Abstract】 Objective To compare the clinical effects of two hemostatic materials in radical resection of patients with papillary thyroid carcinoma and their effects on the drainage fluid parathyroid hormone( d PTH).Methods 82 patients with unilateral papillary thyroid carcinoma admitted to the First Affiliated Hospital of Anhui University of Science and Technology from January 2020 to August 2020 were selected.According to the application of hemostatic materials during the operation,they were divided into hemostatic yarn( surgice) group( n = 29),hemostatic membrane group( n = 27) and control group( n = 26). In the surgice group,surgice was used during the operation,and daqing absorbable hemostatic film( hemostatic film) was used in the hemostatic film group.The control group did not use hemostatic materials during the operation.The differences in postoperative complications,hospitalization costs,length of stay,Postoperative dPTH,postoperative drainage fluid volume and drainage tube withdrawal time( extubation time)were compared among the three groups. Results There was no statistically significant difference between the three groups in operation time,intraoperative blood loss,hospitalization days,postoperative complications and hospitalization expenses( P>0. 05).The amount of drainage fluid in the surgice group and the hemostatic membrane group at 24 h and 48 h was lower than that of the control group( P<0. 05),and the drainage fluid in the surgice group was lower than that in the hemostatic membrane group( P<0. 05).The extubation time of the surgice group and the hemostatic membrane group was shorter than that of the control group( P<0. 05),but there was no significant difference between the surgice group and the hemostatic membrane group( P > 0. 05). There was no significant difference in d PTH levels between the surgice group,the hemostatic membrane group and the control group on the 1 st postoperative day( P>0. 05).The dPTH of the surgice group was lower than that in the hemostatic membrane group and the control group on the 2 nd postoperative day( P<0. 0.05).There was no significant difference in the incidence of postoperative complications among the three groups( χ2= 0.78,P<0.05).Conclusion The use of surgice or hemostatic membrane during the operation of papillary thyroid cancer can effectively reduce postoperative exudation,without increasing postoperative complications and hospitalization costs.Surgice has the effect of reducing exudation earlier than hemostatic membrane,and it may be helpful for early recovery of parathyroid function.更多还原