文章摘要
《甲状腺手术后血肿的处理：系统评价和多学科共识指南》的解读
Interpretation for the management of hematoma after thyroid surgery: systematic review and multidisciplinary consensus guidelines
  
DOI：10.12089/jca.2023.02.020
中文关键词: 甲状腺手术  并发症  术后血肿  困难气道  指南
英文关键词: Thyroid surgery  Complication  Postoperative hematoma  Difficult airway  Guideline
基金项目:
作者单位E-mail
王恒跃 200433,上海市,海军军医大学第一附属医院麻醉科  
纪文焘 200433,上海市,海军军医大学第一附属医院麻醉科  
薄禄龙 200433,上海市,海军军医大学第一附属医院麻醉科 barbo@smmu.edu.cn 
邓小明 200433,上海市,海军军医大学第一附属医院麻醉科  
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中文摘要:
      甲状腺手术后血肿是甲状腺手术后罕见但可致命的并发症，应受到多医疗学科的关注。近期，来自困难气道协会（DAS）、英国内分泌和甲状腺外科医生协会（BAETS）和英国耳鼻咽喉头颈外科协会（ENT UK）共11名专家组成的工作组制定了《甲状腺手术后血肿的处理：系统评价和多学科共识指南》。指南涵盖监测、识别、甲状腺手术后急救箱、甲状腺手术后疑似血肿的管理、血肿清除、日间甲状腺手术、培训、术前沟通和知情同意、术后沟通及机构政策等，并强调多学科团队合作对于保证甲状腺手术患者围术期安全的重要性。虽然该指南是专为甲状腺手术制定，但很多原则也可能适用于头颈部其他类型的手术。甲状腺手术后血肿的紧急决策和处理，需要麻醉科医师的深度参与。麻醉科医师在甲状腺手术后血肿的处理中担任重要角色，故应合理决策，重视氧和，为改善患者预后做出应有的努力。
英文摘要:
      Hematoma after thyroid surgery is a rare but fatal complication after thyroid surgery, which should be paid attention to by multiple medical disciplines. Recently, a working group composed of 11 experts from the Society of Difficult Airways (DAS), the British Association of Endocrine and Thyroid Surgeons (BAETS), and the British Association of Otolaryngology Head and Neck Surgery (ENT UK) developed the treatment of hematoma after thyroid surgery: a multidisciplinary systematic review and joint guidance. The guidelines cover monitoring, identification, first aid kit after thyroid surgery, management of suspected hematoma after thyroid surgery, cognitive assistance, hematoma clearance, daytime thyroid surgery, training, preoperative communication and informed consent, postoperative communication and institutional policies, and emphasize the importance of multidisciplinary team cooperation to ensure perioperative safety of patients undergoing thyroid surgery. Although this guideline was developed specifically for thyroid surgery, many of the principles may also apply to other head and neck surgeries. The emergency decision-making and management of hematoma after thyroid surgery requires the deep participation of anesthesiologists. Anesthesiologists play an important role in the treatment of hematoma after thyroid surgery, so they should make reasonable decisions, pay attention to oxygen balance, and make due efforts to improve the prognosis of patients.
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