以质量求发展,以服务铸品牌

Journal of Nursing ›› 2024, Vol. 31 ›› Issue (2): 59-64.doi: 10.16460/j.issn1008-9969.2024.02.059

Previous Articles     Next Articles

Best evidence summary for prevention and management of neck bleeding after thyroid surgery

LU Ge-linga, LUO Wei-xiangb, OU Jingc, ZHENG Chun-raod   

  1. a. Operating Room; b. Dept. of Nursing Administration; c. Dept. of Tumor Radiotherapy, d. Dept. of General Surgery, Thyroid and Breast Surgery Center, Shenzhen People's Hospital (the Second Clinical Medical College of Jinan University, the First Affiliated Hospital of Southern University of Science and Technology), Shenzhen 518020, China;
  • Received:2023-07-07 Online:2024-01-25 Published:2024-02-20

Abstract: Objective To retrieve and summarize the best evidence for the prevention and management of neck bleeding in patients undergoing thyroid surgery, and to guide clinical practice. Methods Based on the 6S evidence pyramid, guidelines, clinical decision-making, expert consensus, and other relevant literature on the prevention and management of neck bleeding in thyroidectomy were retrieved from the databases. The retrieval period spanned from the inception of the database to June 2023. Two researchers independently evaluated the quality of the literature and extracted the evidence. Results A total of 35 articles were included, including 1 clinical decision-making, 5 guidelines, 13 expert consensuses, and 16 systematic reviews. A total of 46 pieces of evidence were summarized from 7 aspects, including risk management, preventive measures, clinical monitoring, treatment principles, etc. Conclusion We summarizes the best evidence for the prevention and management of neck bleeding after thyroid surgery, providing reference for healthcare professionals to develop management plans for neck bleeding in patients undergoing thyroid surgery.

Key words: thyroid cancer, neck bleeding, management, evidence summary

CLC Number: 

  • R473.58
[1] Iliff HA, El-Boghdadly K, Ahmad I, et al.Management of haematoma after thyroid surgery:systematic review and multidisciplinary consensus guidelines from the Difficult Airway Society, the British Association of Endocrine and Thyroid Surgeons and the British Association of Otorhinolaryngology, Head and Neck Surgery[J]. Anaesthesia, 2022,77(1):82-95. DOI:10.1111/anae.15585.
[2] Liu J,Sun W,Dong W,et al.Risk factors for post-thyroidectomy haemorrhage:a Meta-analysis[J].Eur J Endocrinol, 2017,176(5):591-602. DOI:10.1530/EJE-16-0757.
[3] 中国抗癌协会甲状腺癌专业委员会,中国抗癌协会头颈肿瘤专业委员会,中国研究型医院学会甲状腺疾病专业委员会.甲状腺日间手术中国专家共识(2021版)[J].中国普通外科杂志,2021,30(5):499-509.DOI:10.7659/j.issn.1005-6947.2021.05.001.
[4] 中国抗癌协会甲状腺癌专业委员会护理学组.甲状腺癌加速康复外科围术期护理专家共识[J].护理研究,2022,36(1):1-7.DOI:10.12102/j.issn.1009-6493.2022.01.001.
[5] 朱政,胡雁,邢唯杰,等.不同类型循证问题的构成[J].护士进修杂志,2016,32(21):1991-1994.
[6] Dicenso A,Bayley L,Haynes RB.Accessing pre-appraised evidence:fine-tuning the 5S model into a 6S model[J]. Evid Based Nurs, 2009,12(4):99-101. DOI:10.1136/ebn.12.4.99-b.
[7] 谢利民,王文岳.《临床指南研究与评价系统Ⅱ》简介[J].中西医结合学报,2011,10(2):160-165. DOI:10.3736/jcim20120206.
[8] Brouwers MC,Kho ME,Browman GP, et al.AGREE II:advancing guideline development,reporting and evaluation in health care[J]. CMAJ, 2010,182(18):E839-E842. DOI:10.1503/cmaj.090449.
[9] 张方圆,沈傲梅,强万敏.AMSTAR使用过程中存在的问题及建议[J].中国循证心血管医学杂志, 2017, 10(2):138-142.DOI:10.3969/j.issn.1674-4055.2018.02.03.
[10] 王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,(11):964-967.
[11] Tracy SW, Melanie LL, Julie AS. Thyroidectomy. Up To Date.(2023-08-11)https://www.uptodate.cn/contents/thyroidectomy?search=hematoma%20thyroid&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H28.
[12] 中华人民共和国国家卫生健康委员会医政医管局.甲状腺癌诊疗指南(2022年版)[J]. 中国实用外科杂志,2022(12):1343-1357.
[13] Francis GL, Waguespack SG, Bauer AJ, et al.Management guidelines for children with thyroid nodules and differentiated thyroid cancer[J]. Thyroid, 2015,25(7):716-759.
[14] Haugen BR, Alexander EK, Bible KC, et al.2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines task force on thyroid nodules and differentiated thyroid cancer[J]. Thyroid, 2016,26(1):1-133. DOI:10.1089/thy.2015.0020.
[15] 中华医学会内分泌学分会,中华医学会外科学分会甲状腺及代谢外科学组,中国抗癌协会头颈肿瘤专业委员会,等. 甲状腺结节和分化型甲状腺癌诊治指南(第二版)[J]. 中华内分泌代谢杂志,2023(3):181-226.
[16] 田文,张浩.分化型甲状腺癌术后管理中国专家共识(2020版)[J]. 中国实用外科杂志,2020(9):1021-1028.
[17] 中国抗癌协会头颈肿瘤专业委员会,中国抗癌协会甲状腺癌专业委员会.甲状腺外科ERAS中国专家共识(2018版)[J].中国肿瘤,2019,28(1):26-38.DOI:10.11735/j.issn.1004-0242.2019.01.A004.
[18] 中国医师协会外科医师分会甲状腺外科医师委员会, 中国研究型医院学会甲状腺疾病专业委员会,中国医学装备协会外科装备分会甲状腺外科装备委员会,等.开放性甲状腺手术的切口管理专家共识(2018版)[J].中华内分泌外科杂志,2018,12(4):269-273.DOI:10.3760/cma.j.issn.1674-6090.2018.04.002.
[19] 王平,吴国洋,田文,等. 经口腔前庭入路腔镜甲状腺手术专家共识(2018版)[J]. 中国实用外科杂志,2018(10):1104-1107.
[20] 中国医师协会外科医师分会甲状腺外科医师委员会, 中国研究型医院学会甲状腺疾病专业委员会.机器人手术系统辅助甲状腺和甲状旁腺手术专家共识[J].中国实用外科杂志,2016,36(11):1165-1170.DOI:10.7504/CJPS.ISSN1005-2208.2016.11.08.
[21] 中国医师协会外科医师分会甲状腺外科医师委员会,中国研究型医院学会甲状腺疾病专业委员会,海峡两岸医药卫生交流协会海西甲状腺微创美容外科专家委员会,等.经胸前入路腔镜甲状腺手术专家共识(2017版)[J].中国实用外科杂志,2017,37(12):1369-1373.DOI:10.19538/j.cjps.issn1005-2208.2017.12.14.
[22] 中国医师协会外科医师分会甲状腺外科医师委员会,中国研究型医院学会甲状腺疾病专业委员会.分化型甲状腺癌颈侧区淋巴结清扫专家共识(2017版)[J].中国实用外科杂志,2017,37(9):985-991.DOI:10.19538/j.cjps.issn1005-2208.2017.09.13.
[23] 中国医师协会外科医师分会甲状腺外科医师委员会,中国研究型医院学会甲状腺疾病专业委员会甲状腺手术学组,中国中西医结合学会普通外科专业委员会甲状腺与甲状旁腺专家委员会.局部晚期甲状腺癌手术治疗中国专家共识(2020版)[J].中国实用外科杂志,2020,40(4):369-376.DOI:10.19538/j.cjps.issn1005-2208.2020.04.02.
[24] 中国抗癌协会甲状腺癌专业委员会,中华医学会肿瘤学分会甲状腺肿瘤专业委员会,中国研究型医院学会甲状腺疾病专业委员会,等.无充气腋窝入路腔镜甲状腺手术专家共识(2022版)[J].中华内分泌外科杂志,2021,15(6):557-563.DOI:10.3760/cma.j.cn.115807-20211116-00349.
[25] Menegaux F, Baud G, Chereau N, et al.SFE-AFCE-SFMN 2022 consensus on the management of thyroid nodules:Surgical treatment[J]. Ann Endocrinol (Paris), 2022,83(6):415-422. DOI:10.1016/j.ando.2022.10.012.
[26] 湖南省预防医学会甲状腺疾病防治专业委员会, 湖南省医学会肿瘤学专业委员会甲状腺肿瘤学组, 湖南省医学会普通外科专业委员会乳腺甲状腺学组,等. 甲状腺手术后出血防治管理湖南省专家共识[J].中国普通外科杂志,2023,32(5):627-639.DOI:10.7659/j.issn.1005-6947.2023.05.001.
[27] Corsten M, Johnson S, Alherabi A.Is suction drainage an effective means of preventing hematoma in thyroid surgery? A Meta-analysis[J]. J Otolaryngol, 2005,34(6):415-417. DOI:10.2310/7070.2005.34609.
[28] Jeppesen K,Moos C,Holm T,et al.Risk of hematoma after hemithyroidectomy in an outpatient setting:a systematic review and Meta-analysis[J]. Eur Arch Otorhinolaryngol, 2022,279(8):3755-3767.DOI:10.1007/s00405-022-07312-y.
[29] Hua N, Quimby AE, Johnson-Obaseki S.Comparing hematoma incidence between hemostatic devices in total thyroidectomy: a systematic review and Meta-analysis[J]. Otolaryngol Head Neck Surg, 2019,161(5):770-778. DOI:10.1177/0194599819865248.
[30] Soh TCF,Ong QJ,Yip HM.Complications of neck drains in thyroidectomies: a systematic review and Meta-analysis[J]. Laryngoscope, 2021, 131(3):690-700. DOI:10.1002/lary.29077.
[31] Fan C, Zhou X, Su G,et al.Risk factors for neck hematoma requiring surgical re-intervention after thyroidectomy: a systematic review and Meta-analysis[J]. BMC Surg, 2019,19(1):98. DOI:10.1186/s12893-019-0559-8.
[32] Polychronidis G,Hüttner FJ,Contin P,et al.Network meta-analysis of topical haemostatic agents in thyroid surgery[J]. Br J Surg, 2018, 105(12):1573-1582. DOI:10.1002/bjs.10975.
[33] Tian J, Li L, Liu P, et al.Comparison of drain versus no-drain thyroidectomy: a Meta-analysis[J]. Eur Arch Otorhinolaryngol, 2017,274(1):567-577. DOI:10.1007/s00405-016-4213-0.
[34] Quimby AE,Wells ST,Hearn M,et al.Is there a group of patients at greater risk for hematoma following thyroidectomy? A systematic review and Meta-analysis[J]. Laryngoscope, 2017,127(6):1483-1490. DOI:10.1002/lary.26195.
[35] Sanabria A,Carvalho AL,Silver CE,et al.Routine drainage after thyroid surgery--a Meta-analysis[J]. J Surg Oncol, 2007,96(3):273-280. DOI:10.1002/jso.20821.
[36] Kennedy SA,Irvine RA,Westerberg BD,et al.Meta-analysis:prophylactic drainage and bleeding complications in thyroid surgery[J]. J Otolaryngol Head Neck Surg, 2008,37(6):768-773.
[37] Li L, Chen H, Tao H, et al.The effect of no drainage in patients who underwent thyroidectomy with neck dissection: a systematic review and Meta-analysis[J]. Medicine (Baltimore),2017,96(50):e9052.DOI:10.1097/MD.0000000000009052.
[38] Portinari M,Carcoforo P.The application of drains in thyroid surgery[J]. Gland Surg, 2017,6(5):563-573. DOI:10.21037/gs.2017.07.04.
[39] 周亚雄,刘海鹏,祝占奎,等. 甲状腺和甲状旁腺术后引流与否疗效比较的Meta分析[J]. 兰州大学学报(医学版),2018(2):33-45.
[40] Zhu W,Zhong M,Ai Z.Systematic evaluation of prophylactic neck dissection for the treatment of papillary thyroid carcinoma[J]. Jpn J Clin Oncol, 2013,43(9):883-888. DOI:10.1093/jjco/hyt087.
[41] Samraj K, Gurusamy KS. Wound drains following thyroid surgery[J]. Cochrane Database Syst Rev, 2007,2007(4):CD006099. DOI:10.1002/14651858.CD006099.pub2.
[1] LI Jiang-wei, WANG Shu-jun, LI Chang-zai, HU Bao-shan, JIAO Gui-mei, ZHANG Wei-hong. Effects of nursing intervention based on stress and coping theory on psychological stress, negative emotions and self-management in patients with permanent enterostomy after surgery for colorectal cancer [J]. Journal of Nursing, 2025, 32(4): 64-69.
[2] MA Xiao-lan, XU Wei-fang. Application effect of ice water spray based on symptom management theory in thirsty patients undergoing thoracoscopic lobectomy [J]. Journal of Nursing, 2025, 32(4): 70-73.
[3] WU Chao-yu, LIU Shang-kun. Crisis management competence of nurses in post-anesthesia care unit: a qualitative study [J]. Journal of Nursing, 2025, 32(3): 17-21.
[4] LI Ruo-Yu, LIU Xin, LIN Ping, CHEN Dan, LIN Hua. Best evidence summary for medication safety management for discharged patients [J]. Journal of Nursing, 2025, 32(3): 50-55.
[5] YANG Bei, YE Hong-fang, ZHANG Ning, XIANG Lu-wei, LU Shi-yu. Current status of physical activity and its influencing factors in elderly patients with type 2 diabetes [J]. Journal of Nursing, 2025, 32(2): 7-12.
[6] ZHU Tian-shun, ZHU Ke-ke, XUE Hui-yuan, JIAO Cong-cong, WEI Chang-hui, WANG He. Application of message framing theory in health management: a scoping review [J]. Journal of Nursing, 2025, 32(2): 44-49.
[7] BI Ya-xin, DUAN Ye, HE Li-jun, XU Miao, GONG Rong-hua. Best evidence summary for prevention and management of osteoporosis after metabolic, bariatric surgery [J]. Journal of Nursing, 2025, 32(1): 44-49.
[8] WEN Min, CHEN Bing, ZHOU Yong-ling, LIU Juan, ZHU Xiao-dan. Construction of joint intervention program of cognitive remediation based on mobile health APP for schizophrenia patients [J]. Journal of Nursing, 2024, 31(9): 1-4.
[9] YE Xiang, LI Kai, HUANG Min, ZHANG Qian, LI Ji-min, LIU Rong-zhen, MENG Min, ZHU Shao-yu, XIE Cui-hua. Mobile APP plus family management of blood glucose for adult patients with type 2 diabetes [J]. Journal of Nursing, 2024, 31(9): 60-65.
[10] ZHENG Tao-hua, GAO Xiang, KANG Mei, WEI Hai-xia, LIU Xiao, ZHANG Li. Application of 4R Crisis Management Theory in risk management of hypoglycemia during peri-colonoscopy period [J]. Journal of Nursing, 2024, 31(7): 22-26.
[11] NI Le-feng, LIU Lin, SHEN Chun-hua, QIAO Yao, ZHOU Liang, ZHU Qiang, GONG Wei-juan. Quality evaluation and content analysis of guidelines for time limit management in transfusion nursing [J]. Journal of Nursing, 2024, 31(7): 51-56.
[12] LI Ai-qun, LI Li-hua, WANG Fang, JIANG Yuan-yuan, CAI Yi-min. Mediating effects of chronic disease resource utilization between self-transcendence and self-management behaviors in coronary artery disease patients after PCI [J]. Journal of Nursing, 2024, 31(6): 13-17.
[13] CHEN Fang, YANG Min-fei, YAO Xiao-yue, ZHOU Shi-bo. Construction and practice of intra-hospital nursing security system in designated hospitals for Hangzhou Asian Games [J]. Journal of Nursing, 2024, 31(6): 35-38.
[14] WANG Ling, QIN Fang, GAO Yu-lin, ZHEN Li, FENG Ri-xuan, LIU Bing, MA Zheng-wen, XU Xiao-yu, LI Guo-xin. Best evidence summary of transcutaneous electrical acupoint stimulation for postoperative pain [J]. Journal of Nursing, 2024, 31(6): 51-55.
[15] LUO Xia, LIU Yu-ping, SHUAI Ping, GUAN Hua, YANG Hua, YAO Xiao-qin. Construction of competence performance appraisal scheme for nurses in physical examination center [J]. Journal of Nursing, 2024, 31(5): 30-33.
Viewed
Full text


Abstract

Cited

  Shared   
No Suggested Reading articles found!