甲状腺手术后出血防治管理湖南省专家共识
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Hunan expert consensus on prevention and management of postoperative bleeding after thyroid surgery
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    摘要:

    近年来甲状腺肿瘤发病率迅速增长,甲状腺手术量逐年升高。术后出血及其所致气道压迫是甲状腺手术后最危险的并发症,严重者可致死亡,是潜在的医疗纠纷。为提高对甲状腺术后出血和气道压迫的早期识别,提供必要的专业培训十分重要。及时正确处理术后出血和气道压迫,可以避免风险进一步扩大,造成不可挽回的严重后果。此外,甲状腺术后出血并发症的管理需要外科、麻醉科和护理等多学科团队(MDT)参与。为提高手术安全性,减少术后出血发生率并及时发现和处理,湖南省内相关专家在大量临床经验的基础上结合文献复习,以循证医学为基础共同制定“甲状腺手术后出血防治管理湖南省专家共识”。

    Abstract:

    In recent years, the incidence of thyroid tumors has rapidly increased, leading to a corresponding rise in the number of thyroid surgeries performed annually. Postoperative bleeding and resultant airway compression are the most dangerous complications after thyroid surgery, and in severe cases, can result in death, posing potential medical disputes. Providing necessary professional training is crucial to enhance early recognition of postoperative bleeding and airway compression after thyroid surgery. Timely and appropriate management of postoperative bleeding and airway compression can prevent further complications and irreversible consequences. In addition, the management of complications related to postoperative bleeding after thyroid surgery requires a multidisciplinary team (MDT) involving surgeons, anesthesiologists, and nursing staff. Based on extensive clinical experience and literature review, and grounded on evidence-based medicine, experts from relevant fields in Hunan province have developed a "Consensus on the Prevention and Management of Postoperative Bleeding after Thyroid Surgery", so as to improve surgical safety, reduce the incidence of postoperative bleeding, and facilitate timely detection and management.

    表 1 推荐分级Table 1 Grading recommendations
    图1 甲状腺术后颈前血肿的早期识别(获RightsLink®授权[5])Fig.1 Early recognition of cervical hematoma after thyroid surgery (with RightsLink® authorization[5])
    图2 甲状腺术后出血患者临床管理流程Fig.2 Clinical management protocol for patients with postoperative bleeding after thyroid surgery
    图3 “SCOOP”方法清除颈前血肿、减轻气道压迫(获RightsLink®授权[5])Fig.3 SCOOP method for clearing cervical hematoma and alleviating airway compression (with RightsLink® authorization[5])
    图1 甲状腺术后颈前血肿的早期识别(获RightsLink®授权[5])Fig.1 Early recognition of cervical hematoma after thyroid surgery (with RightsLink® authorization[5])
    图2 甲状腺术后出血患者临床管理流程Fig.2 Clinical management protocol for patients with postoperative bleeding after thyroid surgery
    图3 “SCOOP”方法清除颈前血肿、减轻气道压迫(获RightsLink®授权[5])Fig.3 SCOOP method for clearing cervical hematoma and alleviating airway compression (with RightsLink® authorization[5])
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.甲状腺手术后出血防治管理湖南省专家共识[J].中国普通外科杂志,2023,32(5):627-639.
DOI:10.7659/j. issn.1005-6947.2023.05.001

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  • 收稿日期:2023-04-25
  • 最后修改日期:2023-04-26
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  • 在线发布日期: 2023-11-03