Effect of meglumine diatrizoate injection on volune of drainage after thyroid surgery
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摘要:
目的 探讨泛影葡胺注射液对甲状腺手术后创面引流量的临床效果。 方法 收集2016年5月~2017年5月在佳木斯大学附属第一医院普外二科行开放性甲状腺大部切除术和甲状腺切除术+颈淋巴结清扫术患者共60例，根据术中快速病理报告组分为良性组和恶性组，良、恶性组内分实验组（泛影葡胺组）及对照组（生理盐水组），每组根据病例手术切除范围不同继续分组，即：A良性单侧实验组（8例）、B良性单侧对照组（7例）、C良性双侧实验组（7例）、D良性双侧对照组（8例）、E恶性单侧实验组（8例）、F恶性单侧对照组（9例）、G恶性双侧实验组（7例）、H恶性双侧对照组（6例）。其中实验组患者（30例）术中切除甲状腺病灶或淋巴清扫完成后，彻底止血，取泛影葡胺注射液10 mL均匀冲洗于手术操作创面，吸出残液放置引流；对照组患者（30例）术中主要步骤完成后，彻底止血，取生理盐水冲洗创面，吸出残液放置引流，记录术后组0~8、8~24、24~48 h时间段引流量，观察切口愈合情况。 结果 根据收集各组引流量，比较A/B组、C/D组、E/F组、G/H组引流量数据，观察到使用泛影葡胺注射液作为创面冲洗剂的实验组引流量少于使用生理盐水的对照组，差异有统计学意义（P<0.05）。 结论 泛影葡胺注射液作为创面冲洗剂在甲状腺术中应用可通过减少血液渗出及封闭微小淋巴漏机制来减少术后创面引流量，具有临床推广价值。 Abstract:Objective To investigate the clinical effect of meglumine diatrizoate injection as the wound drainage agent in thyroid surgery. Medthods From May 2016 to May 2017, 60 patients treated with open subtotal thyroidectomy or thyroidectomy plus cervical lymphotomy in the First Affiliated Hospital of Jiamusi University were included and divided into benign group and malignant group according to the rapid pathology report, and each group was further divided into the experimental group (PGD) and the control group (physiological saline group). These groups were further divided, on the basis of resection range, into experimental group A of benign unilateral (n=8), control group B of benign unilateral (n=7), experimental group C of benign bilateral (n=7), control group D of benign bilateral (n=8), experimental group E of malignant unilateral (n=8), control group F of malignant unilateral (n=9), experimental group G of malignant bilateral (n=7), and control group H of malignant bilateral (n=6). For all 30 cases in those experimental groups, a good hemostasis was achieved after the removal of thyroid lesion or lymphadenectomy, and the operative wound was irrigated with 10 mL solution of meglumine diatrizoate injection, after which the drainage was placed. As for the 30 cases of control groups, blood was stopped completely after the completion of major surgical procedures, and the operative wound was irrigated with saline solution and drainage was placed. The drainage flow during the time period of 0-8h, 8-24 h and 24-48 h after the operation was recorded, and the incision was observed to determine the healing effect. Results According collected drainage flow of each group, the drainage flow records of A/B group, C/D group, E/F group, and G/H group were compared. It was observed that the flow rate of experimental groups using meglumine diatrizoate injection as the wound drainage agent was less than that of control groups using saline solution, and the difference was statistically significant (P<0.05). Conclusion The application of meglumine diatrizoate injection as wound drainage agent in thyroid surgery can reduce the postoperative wound flow, thus worthy for extending in clinic. -
表 1 良性实验组与对照组平均引流量（Mean±SD）
分组 单侧（实验8人，对照组7人） 双侧（实验组7人，对照组8人） 0~8 h 8~24 h 24~48 h 0~8 h 8~24 h 24~48 h 良性实验组 10.00±1.93 5.00±0.93 2.16±0.35 14.50±5.07 5.00±1.51 3.00±0.76 良性对照组 19.71±4.46 13.57±2.07 7.43±2.76 35.29±9.03 11.57±3.10 8.86±1.35 t –5.612 –10.106 –5.047 –5.597 –5.101 –10.586 P 0.000 0.000 0.002 0.000 0.001 0.000 
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表 2 恶性实验组与对照组平均引流量（Mean±SD）
分组 单侧（实验组8人，对照组9人） 双侧（实验组7人，对照组6人） 0~8 h 8~24 h 24~48 h 0~8 h 8~24 h 24~48 h 恶性实验组 12.50±2.07 10.50±1.31 8.13±1.89 21.00±6.32 10.14±5.18 7.29±4.46 恶性对照组 26.78±3.53 19.56±4.50 16.78±3.99 45.00±20.25 17.33±3.50 13.50±2.07 t –9.998 –5.765 –5.586 –2.789 –2.876 –3.293 P 0.000 0.000 0.000 0.033 0.015 0.010
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