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沈薇.小切口甲状腺手术与腔镜甲状腺手术患者的围手术护理[J].上海护理,2017,17(8):
小切口甲状腺手术与腔镜甲状腺手术患者的围手术护理
DOI：
中文关键词:  小切口  腔镜  甲状腺切除术  围手术期护理
英文关键词:small incision  endoscopy  thyroidectomy  Perioperative nuring
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作者单位E-mail
沈薇* 复旦大学附属华山医院北院普外科 上海 201906 shenwei15@qq.com 
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中文摘要:
      目的：探讨小切口与腔镜甲状腺切除术两种不同的微创手术在围手术期护理方法和观察要点；方法：回顾性分析2014年6月至2015年12月我院63例甲状腺切除术患者的围手术期护理资料,其中颈部小切口手术组31例,腔镜手术组32例,分析两组患者手术时间,术中出血量,术后引流量,术后引流天数,住院时间,患者满意度及并发症 (皮下气肿,皮下瘀斑,切口感染,声音嘶哑,高碳酸血症等)等指标。结果：小切口组出现4例切口水肿；腔镜组术后出现3例皮下气肿、 5例胸前皮下瘀斑；经对症处理后63例患者均在术后5天痊愈出院。结论：小切口与腔镜甲状腺切除术在不增加手术并发症及平均住院时间条件下都具有良好的美容效果,能满足不同人群的手术需要。其中,在围手术期的护理观察中对小切口甲状腺切除术患者因注重伤口水肿的观察,而对腔镜甲状腺切除术患者术后更因关注皮下气肿和皮下瘀斑的观察此对手术成功至关重要。
英文摘要:
      Objective: To investigate the perioperative nursing in small incision and endoscopic thyroidectomy. Methods: A retrospective analysis of perioperative nursing data of thyroidectomy patients was conducted. In this study, 31 patients undergoing small incision thyroidectomy in our hospital between June 2014 and December 2015 were enrolled and compared with 32 cases with endoscopic surgery. Operative time, blood loss, postoperative drainage, postoperative drainage for several days, hospital stay, patient satisfaction and complications (subcutaneous emphysema , chest ecchymosis ,wound infection, hoarseness, hypocalcemia and convulsions) were observed. Results: There were four cases of incision edema in small incision group. In the endoscopic group, there were 3 cases of subcutaneous emphysema and 5 cases of chest ecchymosis. all patients were treated properly. All the 63 patients were discharged 5 days after the surgery. Conclusion: Small incision and endoscopic thyroidectomy had better cosmetic effect without increasing the complication and the average length of stay, and could meet the needs of different patients. Actually, the perioperative careful and meticulous care is very important in mall incision and endoscopic thyroidectomy.
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