增加甲状腺手术后血肿发生可能性的因素。

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-02-12 DOI:10.1002/hed.28096

Emily Ajit-Roger, Jessica Hier, Marco Mascarella, Koorosh Semsar-Kazerooni, Sabrina Daniela Silva Wurzba, Véronique-Isabelle Forest, Michael P. Hier, Alex Mlynarek, Carmelina Mancini, Richard J. Payne

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引用次数: 0

摘要

背景：甲状腺手术后颈部血肿是一种潜在的危及生命的并发症。方法：本回顾性病例对照研究回顾了甲状腺手术后颈部血肿再手术（2009-2024），采用3:1匹配。单变量分析确定血肿和延迟发作（≥6小时）的危险因素，优势比（ORs）和95%置信区间（ci）。结果：5502例手术中，血肿发生率为0.55% （n = 30）。平均年龄54岁，男女比例为7:3。关键危险因素包括诱导前血压> 160 mmHg （OR = 3.04 [95% CI = 1.25-7.39], p = 0.014）和用药后血压变化有限（OR = 6.25 [95% CI = 1.03-38.08], p = 0.047）。血肿组吸烟、高血压、糖尿病、Graves病和既往甲状腺手术的发生率较高，迟发性血肿患者有较大结节、全甲状腺切除术和中枢性颈部清扫，但没有统计学意义。结论：血压控制不佳的患者可能不适合进行门诊甲状腺切除术。

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Factors Increasing the Likelihood of Postoperative Hematomas Following Thyroid Surgery

Background

Neck hematoma following thyroid surgery is a potentially life-threatening complication.

Methods

This retrospective case–control study reviewed neck hematoma reoperations following thyroid surgery (2009–2024), using 3:1 matching. Univariable analysis identified hematoma and delayed onset (≥ 6 h) risk factors, with odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Among 5502 surgeries, the hematoma incidence was 0.55% (n = 30). The mean age was 54 and the female-to-male ratio was 7:3. Key risk factors included pre-induction blood pressure > 160 mmHg (OR = 3.04 [95% CI = 1.25–7.39], p = 0.014) and limited blood pressure change postmedication (OR = 6.25 [95% CI = 1.03–38.08], p = 0.047). The hematoma group had higher rates of smoking, hypertension, diabetes, Graves' disease, and prior thyroid surgery, and, in delayed hematoma cases, larger nodules, total thyroidectomy, and central neck dissection, though not statistically significant.

Conclusion

Patients with poorly controlled blood pressure may not be candidates for outpatient thyroidectomy.

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.