三种内径引流管用于甲状腺次全切除术后引流疗效的比较分析

目的 探讨3种内径引流管用于甲状腺次全切除术后引流的效果.方法 选择2010年1月～2012年12月在浙江省宁波市北仑区人民医院行甲状腺次全切除术的患者155例,随机分为T管组、硅胶管组、脑室管组,比较三组患者手术时间、置管时间、切口愈合情况及术后导管相关并发症发生率.结果T管组、硅胶管组和脑室管组的手术时间分别为（91.1±7.4）、（103.6±12.1）、（107.7±14.1）min,T管组手术时间明显短于硅胶管组和脑室管组（P＜0.05）,而硅胶管组和脑室管组比较,差异无统计学意义（P＞0.05）；T管组、硅胶管组和脑室管组的置管时间分别为（1.8±0.4）、（2.0±0.5）、（3.4±0.5）d,脑室管组置管时间明显长于T管组和硅胶管组（P＜0.05）,而T管组和硅胶管组比较差异无统计学意义（P＞0.05）；硅胶管组及脑室管组术中置管时出现皮下出血,两组比较,差异无统计学意义（11.59％比11.11％,P＞0.05）；脑室管组管腔堵塞率明显高于其他两组（15.56％比2.90％,2.44％,P＜0.05）,其他两组之间差异无统计学意义（2.90％比2.44％,P＞0.05）；T管组颈前不适感发生率明显高于其他两组（19.51％比2.90％,4.44％,P＜0.05）,其他两组相比,差异无统计学意义（2.90％比4.44％,P＞0.05）.结论 三种内径引流管用于甲状腺次全切除术后均能有效引流.硅胶负压引流管置管时间短,术后颈前不适感轻微,切口愈合良好,无明显并发症,值得临床推广.

The comparative analysis of drainage effect of three different drainage tube in subtotal thyroidectomy

Objective To investigate the drainage effect of three different drainage tube in subtotal thyroidectomy. Methods 155 patients visited in Beilun District People＇s Hospital of Ningbo City from January 2010 to December 2012 treated with subtotal thyroidectomy were enrolled in our study, and were randomly divided into T drainage tube group, silicone tube group and ventricular drainage tube group. The operation time, drainage tube detaining time, inci- sion condition and the rate of catheter-related complication of three groups were recorded and compared. Results The operation time of three group was （91.1＋_7.4）, （103.6＋12.1）, （107.7＋_14.1） min respectively. The operation time of T drainage tube group was significantly shorter than two other groups （P 〈 0.05）, but there was no statistically difference between silicone tube group and ventricular drainage tube group （P 〉 0.05）. Drainage tube detaining time of three groups were （1.8＋_0.4）, （2.0＋_0.5）, （3.4＋0.5） d respectively. Drainage tube detaining time of ventricular drainage tube group was significantly longer than two other groups （P 〈 0.05）, but there was no statistically difference between sili- cone tube group and T drainage tube group （P 〉 0.05）. Subcutaneous hemorrhage appeared in silicone tube group and ventricular drainage tube group, but no statistically difference between the two groups （11.59% vs 11.11%, P 〉 0.05）. The rate of tube block in ventricular drainage tube group was higher than two other groups （15.56% vs 2.90%, 2.44%, P 〈 0.05）, also no statistically difference was found in the two other groups （2.90% vs 2.dd%, P 〉 0.05）. The rate of discomfortableness in T drainage tube group was higher than two other groups （19.51% vs 2.90%, 4.44%, P 〈 0.05）, also no statistically difference was found in the two other groups （2.90% vs 4.44%, P 〉 0.05）. Conclusion Three dif- ferent drainage tubes are all effective in subtotal thyroidectomy. The silicone tube with shorter detaining time, slighter discomfortableness, better incision condition and without complication, is worthy for spreading in clinical oractice.