Postoperative bleeding and coagulation hemothorax is the primary cause for re-operation after general thoracic surgical procedures. We should do a good job in the assessment of preoperative factors to increase the operation control. This article mainly introduces the thoracic surgery bleeding quantitative assessment, bleeding location and cause, hemostasis, transfusion trigger, pleural drainage tube selection, surgical complications, enhanced recovery after surgery and so on.
ObjectiveTo explore the risk factors and bleeding points associated with postoperative hemorrhage after thyroidectomy and provide clinical basis for prevention of postoperative bleeding.MethodsThe clinical data of 21 patients with postoperative hemorrhage and 63 patients without postoperative hemorrhage who underwent thyroidectomy from Nov. 2010 to Nov. 2017 in West China Hospital were retrospectively analyzed.ResultsUnivariate analysis showed that hypertension, maximum tumour dimension, lymph node metastasis, recurrent laryngeal nerval infiltration, T stage, N stage, serum triglyceride, and serum high density lipoprotein were significantly associated with postoperative hemorrhage (P<0.05). Multivariate analysis showed that lymph node metastasis (OR=16.219, P=0.002) and low serum high density lipoprotein (OR=0.035, P=0.006) were risk factors for postoperative hemorrhage. Among the patients with postoperative bleeding, the most common five bleeding sites were: ribbon muscle and sternocleidomastoid muscle (both was 19.2%), esophageal tracheal surface blood vessels (11.5%), thyroid bed (7.7%), and larynx recurrent paravascular small vessels (7.7%).ConclusionsLymph node metastasis and serum HDL are independent risk factors of hemorrhage after thyroidectomy. The predilection site for postoperative bleeding is mainly the neck muscle.
Percutaneous renal puncture biopsy is an invasive procedure, and there are still some risks in its application. Bleeding after puncture is a major risk of percutaneous renal biopsy. In order to improve the safety of percutaneous renal puncture biopsy, clinical researchers have been exploring and studying the possible etiology, risk factors and prevention measures of postoperative bleeding in recent years. It is of great significance to clarify the risk factors of bleeding after percutaneous renal puncture biopsy and take timely targeted measures to reduce the risk to the maximum extent for improving the control effect of postoperative bleeding and other complications. This article intends to analyze and summarize the clinical research progress on the occurrence and risk factors of bleeding after percutaneous renal biopsy, in order to provide reference for the prevention and treatment of bleeding after percutaneous renal puncture biopsy.