不同负压引流在甲状腺癌手术中的疗效和安全性比较分析

摘要 背景：负压引流已广泛应用预防甲状腺手术后的血清肿形成。然而不同负压的引流选择主要取决于外科医生的经验和偏好。本研究的目的是前瞻性的比较低负压和高负压引流在加转型手术后的引流效果。 方法：这项前瞻性的研究试验（2020年1月1日至2020年12月31日）涉及在我院甲状腺乳腺外科收治的120例甲状腺癌手术患者，低负压（120mmHg）和高负压引流组(600mmHg)各60例，主要研究终点是引流管放置天数，次要研究终点是术后第一天引流量、第二天引流量、总引流量和术后疼痛评分。 结果：根据引流天数比较，低负压引流组术后平均引流天数（3.07±0.69天）相比于高负压引流组（3.58±0.70天）明显减少，且有统计学意义（P＜0.05）。低负压引流组和高负压引流组在术后第一天的引流量和术后疼痛评分方面无明显差异（P＞0.05），而在比较术后第二天引流量和总引流量方面，低负压引流组相比于高负压引流组都明显减少，且差异有统计学意义（P＜0.05）。 结论：这项针对接受不同负压引流的甲状腺乳头状癌患者的随机对照研究表明，与高负压引流相比，使用低负压引流具有相似的引流安全系数、更少的引流天数和引流总量。因此，我们更推荐甲状腺癌术后患者采用低负压引流。

Comparative analysis of the efficacy and safety of different negative pressure drainage in thyroid cancer surgery

Background: Negative pressure drainage has been widely used to prevent seroma formation after thyroid surgery.However, the choice of different negative pressure drainage mainly depends on the surgeon''s experience and preference.?The purpose of this study was to prospectively compare the drainage effects of low negative pressure and high negative pressure drainage after addition of transformation surgery. Methods:?This prospective study (January 1, 2020 to December 31, 2020) involved 120 patients undergoing thyroid cancer surgery admitted to the department of thyroid and breast surgery of our hospital, including 60 patients in the low negative pressure (120 MMHG) group and 60 patients in the high negative pressure drainage group (600mmHg). The primary endpoint was the number of days of drainage tube implantation.?Secondary study endpoints were postoperative day 1 drainage, day 2 drainage, total drainage, and postoperative pain score. Results: According to the number of drainage days, the average number of postoperative drainage days in the low negative pressure drainage group (3.07±0.69 days) was significantly reduced compared with the high negative pressure drainage group (3.58±0.70 days), and there was statistical significance (P < 0.05).?There was no significant difference between the low negative pressure drainage group and the high negative pressure drainage group in terms of drainage volume and postoperative pain score on the first day after surgery (P > 0.05), while in terms of drainage volume and total drainage volume on the second day after surgery, the low negative pressure drainage group was significantly lower than the high negative pressure drainage group, and the difference was statistically significant (P < 0.05). Conclusions: In this randomized controlled study of patients with papillary thyroid carcinoma who received different negative pressure drainage, low negative pressure drainage had a similar coefficient of drainage safety, fewer days of drainage, and fewer total drainage volumes compared with high negative pressure drainage.?Therefore, low negative pressure drainage is more recommended for postoperative patients with thyroid cancer.