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投稿时间：2021-03-04 网络发布日期：2021-10-20
投稿时间：2021-03-04 网络发布日期：2021-10-20
中文摘要: 目的 探讨颈托在治疗甲状腺癌术后淋巴漏的应用价值。
方法 回顾性分析2009年7月至2020年5月在辽宁省人民医院甲状腺乳腺外科和大连医科大学附属第二医院甲状腺外科行甲状腺癌根治术（单侧腺叶+峡部+同侧中央区淋巴结清扫）术后出现淋巴漏13例患者，其中2019年3月至2020年5月的5例患者为颈托组，给予颈托加压包扎、棉球内填塞、持续负压吸引、低脂饮食。2009年7月至2019年2月的8例患者为对照组，给予弹力绷带加压包扎、持续负压吸引、禁食禁水及肠外营养治疗。对比两组患者治疗天数、引流量<10 ml/d所用时间、换药时间及治疗淋巴漏的费用。
结果与对照组相比，颈托组在治疗天数[（13.8±0.7）d vs （16.0±0.9）d，t =5.887， P <0.01]、引流量<10 ml所用时间[（10.9±1.0）d vs （13.6±1.2）d， t =5.294， P <0.01]、换药时间[（19.1±2.6）min vs （26.0±3.5）min， t =4.640， P <0.01]、治疗淋巴漏的费用[（2 937.5±978.2）元 vs （10 745.5±3 115.0）元， t = 6.803， P <0.01]均较低，两组差异有统计学意义。
结论 颈托加压包扎+棉球内填塞+持续负压吸引+低脂饮食是治疗甲状腺癌术后淋巴漏的可行且简单有效的方法。
Abstract:Objective To explore the value of cervical collar in the treatment of postoperative lymphatic leakage in the patients with thyroid carcinoma.
Methods A retrospective analysis was performed on the data of 13 patients with lymphatic leakage after radical thyroidectomy (including unilateral glandular lobe, isthmus and ipsilateral central lymph node dissection) from July 2009 to May 2020. There were five patients treated with neck support compression bandaging, cotton ball packing, continuous negative pressure suction and low-fat diet in neck support group from March 2019 to May 2020, and eight patients treated with elastic bandage compression dressing, continuous negative pressure suction, fasting and water deprivation and parenteral nutrition in control group from July 2009 to February 2019. The treatment days, the time taken for drainage volume less than 10 ml/d, the time of dressing change and the cost of treating lymphatic leakage were compared between two groups.
Results Compared with control group, the treatment days[（13.8±0.7）d vs （16.0±0.9）d， t =5.887， P <0.01], the time taken for drainage volume <10 ml/d[（10.9±1.0）d vs （13.6±1.2）d， t =5.294， P <0.01], the time of dressing change[（19.1±2.6）min vs （26.0±3.5）min， t =4.640， P <0.01] and the cost of treating lymphatic leakage[（2 937.5±978.2）yuan vs (10 745.5±3 115.0）yuan， t =6.803， P <0.01] 〖JP3〗significantly decreased in neck support group.
Conclusion It is a feasible, simple and effective method that cervical collar compression bandaging, cotton ball packing, continuous negative pressure suction and low-fat diet are applied to treat the postoperative lymphatic leakage in patients after thyroid cancer surpgery.
keywords: Lymphatic leakage Thyroid carcinoma Cervical collar Compression bandage Negative pressure suction Drainage volume
文章编号： 中图分类号： 文献标志码：B
基金项目:辽宁省基层卫生计生适宜技术推广项目（辽卫传[2017]284号-11）；西宁市第二批“引才聚555计划”柔性引进领军人才（宁人才字[2019]4号）
引用文本：
高洋,崔建春,费翔,等.颈托在治疗甲状腺癌术后淋巴漏中的应用[J].中国临床研究,2021,34(10):1366-1369.
高洋,崔建春,费翔,等.颈托在治疗甲状腺癌术后淋巴漏中的应用[J].中国临床研究,2021,34(10):1366-1369.