甲状腺 と 副甲状腺 の 手術 後 の 24 時間 の 観察: 真 に 必要 か
Chandler A Annesi1, Andrea Gillis1, Jessica M Fazendin1
1University of Alabama at Birmingham, Department of Surgery, Birmingham, Alabama.
The Journal of surgical research
|August 20, 2025
まとめ
甲状腺および副甲状腺手術後の中央頸部血腫 (CNH) は稀である (0. 4%). ほとんどのCNHは24時間後に発生し,病院のベッドが限られている場合でも,同日の退院は安全である可能性があることを示唆しています.
科学分野:
- 手術腫瘍学
- 内分泌 の 手術
- 患者の安全
背景:
- 中枢頸部血腫 (CNHs) は 甲状腺切除術と副甲状腺切除術後の 希少だが深刻な合併症である.
- CNHへの恐怖はしばしば長期の入院につながり,ベッド不足を引き起こし,外科手術の能力を制限します.
研究 の 目的:
- 甲状腺および副甲状腺手術後のCNHの発生率とタイミングをレビューする.
- 病院のベッド不足と外科手術の必要性の増大の文脈で,同じ日の退院の安全性を評価する.
主な方法:
- 甲状腺および副甲状腺手術に関する単一機関データベースの展望調査 (2016年から2022年)
- 1614人の患者の分析で,CNHのタイミング,患者の特徴,併発症,およびリスク要因に焦点を当てた.
主要な成果:
- 甲状腺切除術 (0. 7%) の発生率は,副甲状腺切除術 (0. 1%) よりも高い.
- 大半のCNH (57%) は手術後48時間以上で発生し,PACU退院後24時間以内に発生したのは1人だけでした.
- 抗凝固/抗血小板療法 (57%) とグレイス病 (43%) がリスク因子であり,CNHに関連する罹病率や死亡率は報告されなかった.
結論:
- 甲状腺および副甲状腺手術後のCNHは,主にPACUで直ちに発生するか,手術後の24時間以上で発生する.
- ヘマトーマの排出による効果的な治療は死亡率をもたらさなかった.
- 甲状腺および副甲状腺の手術は,24時間の長期観察の必要性を回避して,外科医の診察室で安全に実施できます.
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