首页|铜绿假单胞菌注射液治疗机器人甲状腺癌术后乳糜漏的临床分析

铜绿假单胞菌注射液治疗机器人甲状腺癌术后乳糜漏的临床分析

Clinical analysis of pseudomonas aeruginosa injection in the treatment of postoperative chylous leakage in robotic thyroid cancer

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目的 探讨铜绿假单胞菌注射液(pseudommonas aeruginosa in jection,PAI)治疗机器人甲状腺癌颈部淋巴结清扫术后乳糜漏的安全性和有效性.方法 回顾性分析2021年1月至2023年8月解放军第九六○医院甲状腺乳腺外科机器人甲状腺手术的1 262例,28例术后发生乳糜漏.根据是否使用PAI分为对照组和注射组,对照组15例,男4例,女11例,年龄(46.20±9.02)岁,采用低脂饮食、负压吸引、加压包扎等治疗方法;注射组13例,男7例,女6例,年龄(41.00±8.87)岁,除采用低脂饮食、负压吸引、加压包扎的治疗方法外,注射PAI.统计分析两组淋巴结清扫(lymph node dissection,LND)数量、总引流量、引流量峰值、住院天数及注射组使用PAI后24 h内引流量下降率、注射后体温、注射次数、注射后拔管时间等指标.采用独立样本t检验、Mann-Whitney U检验、x2检验或Fisher's精确检验进行组间比较.结果 两组年龄、性别、甲状腺切除范围、最高日引流量、总引流量差异均无统计学意义(P>0.05).注射组和对照组的LND数量为(49.15±23.05 vs.30.80±11.76)枚(P=0.012),住院时间为(11.77±4.64vs.16.40±6.42)d(P=0.041),差异均有统计学意义.注射组使用PAI后,引流液较前一天下降69.56%±20.82%;12例注射1次PAI后顺利拔管,1例注射2次后顺利拔管;注射后平均拔管时间为(3.85±1.28)d;76.9%(10/13)患者使用PAI后48h之内出现发热症状,注射后体温(38.05±0.89)℃,对症处理后体温恢复正常,除发热外无其他不良反应.结论 PAI治疗机器人甲状腺癌颈部LND术后乳糜漏安全有效,可有效减少颈部引流量,缩短住院天数.
Objective To investigate the safety and efficacy of pseudomonas aeruginosa Injection(PAI)in the treatment of coeliac leakage after cervical lymph node dissection for robotic thyroid cancer.Methods Ret-rospective analysis of 1262 patients who underwent robotic thyroid surgery at the 960th Hospital of the People's Liberation Army from Jan.2021 to Aug.2023 was made.Postoperative celiac leakage happened in 28 patients.The control and injection groups were divided according to whether pseudomonas aeruginosa injection was used or not.In the control group,there were 4 males and 11 females out of 15 patients,with an average age of(46.20±9.02)years old,and the treatment methods of low-fat diet,negative pressure suction,and pressure bandage were used.In the injection group,there were 7 males and 6 females among 13 patients,with an average age of(41.00±8.87)years.They were treated with low-fat diet,negative pressure suction,pressure bandage,and PAI.The number of lymph node dissection,total drainage volume,peak drainage volume,days of hospitalization and the rate of decline in drainage volume within 24 h after the use of PAI in the injection group,post-injection temperature,number of in-jections,and post-injection extubation time were statistically analyzed in both groups.Independent samples t test,Mann-Whitney U test,x2 test or Fisher's exact test were used for comparison between groups.Results There was no statistically significant difference in age,gender,extent of thyroidectomy,highest daily drainage volume,and to-tal drainage volume between the two groups(P>0.05).The difference in the number of lymph node dissection(49.15±23.05 vs.30.80±11.76,P=0.012)and hospitalization time(11.77±4.64 vs.16.40±6.42,P=0.041)between the injection group and the control group was statistically significant.After the use of pseudomonas aeruginosa in-jection,the draining fluid decreased from the previous day(69.56±20.82)%in the injection group;Twelve pa-tients were successfully extubated after one injection of pseudomonas aeruginosa injection,and one patient was suc-cessfully extubated after two injections;the mean time to extubation after injection was(3.85±1.28)days;76.9%pa-tients(10/13)had fever symptoms within 48 h with body temperature(38.05±0.89)℃ after injection,body tempera-ture returned to normal after symptomatic treatment,and no other adverse reactions occurred except fever.Conclu-sion Pseudomonas aeruginosa injection is safe and effective in the treatment of celiac leakage after cervical lymph node dissection for robotic thyroid cancer,effectively reducing cervical drainage and shortening hospitalization days.

Pseudomonas aeruginosa injectionChylous leakageRobotic surgeryThyroid cancerCervical lymph node dissection

任晴玉、王刚、刘永祥、胥浩、于芳、贺青卿

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解放军第九六○医院甲状腺乳腺外科,济南 250031

铜绿假单胞菌注射液 乳糜漏 机器人外科 甲状腺癌 颈部淋巴结清扫术

济南市临床医学科技创新计划山东省医药卫生发展计划

202019010202204011069

2024

中华内分泌外科杂志
中华医学会

中华内分泌外科杂志

CSTPCD
影响因子:0.657
ISSN:1674-6090
年,卷(期):2024.18(1)
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