探讨日间手术模式下甲状腺切除术后出血的应对方案与措施。

回顾性分析2020年8月至2023年4月5929例甲状腺日间手术患者临床资料。

日间甲状腺术后出血患者12例，出血发生率为0.2%。发生术后出血的平均时间为（10.5±10.4）h，范围1 h~36 h。其中11例为在院患者，1例为出院患者。1例患者腔镜下甲状腺切除术后采取全身麻醉腔镜下止血，10例患者采取局部麻醉下开放手术清除血肿，1例患者采取颈部压迫保守治疗。8例患者退出日间手术转入普通病房观察，1例再次入院患者经绿色通道处理后同样转入普通病房，3例患者完成日间手术流程，于48 h内出院。所有患者均未发生二次出血，均痊愈出院。

日间手术是提升医疗资源利用率的重要方式，甲状腺术后出血是影响日间甲状腺切除术可行性与安全性的重要因素，详细的术前健康宣讲以及妥善的处理方式能够保证患者的安全。

To explore the coping plan and measures of hemorrhage after thyroidectomy in day operation mode.

The data of 5929 patients with daytime thyroid surgery from August 2020 to April 2023 were retrospectively analyzed.

There were 12 patients with hemorrhage after daytime thyroid surgery, the incidence of hemorrhage was 0.2%. The mean time of postoperative bleeding was (10.5±10.4) h, ranging from 1 h to 36 h. Eleven of the patients were hospitalized and one was discharged. One patient underwent endoscopic hemostasis under general anesthesia after thyroidectomy, 10 patients underwent open surgery under local anesthesia to remove hematoma, and 1 patient underwent conservative treatment with neck compression. Eight patients withdrew from the day operation and were transferred to the general ward for observation, one readmitted patient was also transferred to the general ward after green channel treatment, and three patients completed the day operation procedure and were discharged within 48 hours. No secondary bleeding occurred in all patients, and all patients were cured and discharged from hospital.

Daytime surgery is an important way to improve the utilization rate of medical resources, and postoperative thyroid bleeding is an important factor affecting the feasibility and safety of daytime thyroidectomy. Detailed preoperative health promotion and proper treatment can ensure the safety of patients.