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目的探究并分析分化型甲状腺癌患者根治术术中、术后并发症情况及其影响因素。方法研究对象来自我院2010年1月—2013年1月收治的375例分化型甲状腺癌根治术患者,采用笔者查阅大量参考文献后编制的自编问卷收集分化型甲状腺癌根治术患者临床资料,采用描述性统计和二分类Logistic回归分析找出分化型甲状腺癌患者根治术术中、术后并发症情况及其影响因素。结果分化型甲状腺癌患者根治术术中、术后并发症发生率为14.40%(54/375),以手术部位感染、喉返神经损伤和低钙血症为多见。单因素Logistic回归分析示高龄(OR=6.22,P=0.000)、淋巴结远处转移(OR=6.41,P=0.000)、营养不良(OR=16.83,P=0.000)、糖化血红蛋白水平高(OR=18.79,P=0.000)、基础疾病种类>3种(OR=4.88,P=0.000)和侵入性操作>3种(OR=4.58,P=0.000)是分化型甲状腺癌患者出现术中、术后并发症的危险因素。多因素Logistic回归分析示高龄(OR=6.92,P=0.000)、营养不良(OR=10.04,P=0.000)和糖化血红蛋白水平高(OR=12.87,P=0.000)是分化型甲状腺癌患者出现术中、术后并发症的危险因素。结论分化型甲状腺癌患者术中、术后并发症发生率较高,以手术部位感染、喉返神经损伤和低钙血症为多见,其发生受多方面因素影响,在临床工作中,我们应该强化医务人员患者营养支持重要性,优化血糖控制方案,有效控制血糖,尤其是针对高危人群,减少分化型甲状腺癌患者术中、术后并发症发生,改善患者的预后。
Objective To investigate and analyze the intraoperative and postoperative complications and its influencing factors in radical thyroidectomy patients with differentiated thyroid cancer. Methods The subjects were from 375 patients with differentiated thyroidectomy undergoing radical resection in our hospital from January 2010 to January 2013. The clinical data of patients with differentiated thyroid cancer undergoing radical operation were collected using a self-made questionnaire prepared by the author after consulting a large number of references, Descriptive statistics and binary logistic regression analysis were used to find out the postoperative complications and its influencing factors in patients with differentiated thyroid cancer. Results The incidence of postoperative complications in patients with differentiated thyroid cancer was 14.40% (54/375). Surgical site infection, recurrent laryngeal nerve injury and hypocalcemia were more common. Univariate Logistic regression analysis showed that age (OR = 6.22, P = 0.000), distant lymph node metastasis (OR = 6.41, P = 0.000), malnutrition (OR = 16.83, P = 0.000) and high HbA 1c (OR = (OR = 4.88, P = 0.000) and invasive operation> 3 (OR = 4.58, P = 0.000) were significantly different between patients with differentiated thyroid cancer and those with differentiated thyroid cancer (18.79, P = 0.000) Risk factors for complications. Multivariate logistic regression analysis showed that patients with differentiated thyroid cancer showed higher age (OR = 6.92, P = 0.000), malnutrition (OR = 10.04, P = 0.000) and high HbA 1c (OR = 12.87, P = 0.000) Medium and postoperative complications of risk factors. Conclusion The incidence of intraoperative and postoperative complications in patients with differentiated thyroid cancer is high. Surgical site infection, recurrent laryngeal nerve injury and hypocalcemia are more common, and their occurrence is affected by many factors. In the clinical work, we It is necessary to strengthen the importance of nutritional support for medical staff, optimize blood sugar control program and effectively control blood sugar, especially for high-risk groups, to reduce intraoperative and postoperative complications in patients with differentiated thyroid cancer and improve prognosis.