갑상선 절제술 후 출혈의 발생 빈도와 주술기 기간의 혈압 및 맥박수 증가: 후향적 환자 사례군 연구

Perioperative hypertension, tachycardia event, and incidence of postoperative hemorrhage after thyroidectomy: retrospective case series study

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Background: The frequency of post-thyroidectomy hemorrhage is low, 0.43% to 2.83%, but when it occurs, life-threatening problems such as airway compression can arise. Therefore, risk factors associated with postoperative hemorrhage should be well understood. Male, old age, hypertension, anticoagulation history, neck dissection, and bilateral thyroidectomy are the known risk factors and most bleeding occurs within the first day of the surgery. Methods: This retrospective study analyzes not only the bleeding frequency after thyroidectomy performed between 2016 and 2021, but also hypertensive and tachycardia events during the perioperative period. Results: There were 20 cases of postoperative hemorrhage over 6 years, and the incidence rate was 0.68%. Most postoperative hemorrhage was detected within 12 hours after surgery (≥75%). The incidence rate of postoperative hemorrhage was the same in both sexes, 4 patients underwent thyroidectomy, and 16 patients underwent thyroidectomy with neck dissection. Only 8 patients were previously diagnosed with hypertension, and 2 patients were taking anticoagulants. All patients with postoperative hemorrhage had hypertensive event I during the perioperative period, and 95% of patients had tachycardia event I. Conclusion: It is necessary to recognize the possibility of bleeding after surgery and to actively control hypertension and tachycardia, rather than understanding the findings of increased blood pressure and heart rate occurring during the perioperative period as temporary phenomena and proceeding without additional treatment. In addition, within 12 hours after surgery, when postoperative hemorrhage occurs the most, these patients should be classified into a risk group and closely monitored.