中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
23期
14-16
,共3页
甲状腺切除术%超声刀%精细化被膜解剖技术
甲狀腺切除術%超聲刀%精細化被膜解剖技術
갑상선절제술%초성도%정세화피막해부기술
Thyroidectomy%Harmonic scalpel%Meticulous capsular dissection technique
目的 探讨甲状腺精细化被膜解剖技术中超声刀的应用体会,分析其安全性和疗效.方法 选择应用超声刀对血管进行骨骼化为核心的精细化被膜解剖技术的甲状腺手术患者135例(超声刀组),并选择应用传统手术器械的精细化被膜解剖技术的甲状腺手术患者140例(传统组).观察比较两组的腺体切除时间、术中出血量、术后引流量及术后并发症发生情况.结果 两组患者均痊愈出院.超声刀组甲状腺全切除术、甲状腺次全切除术患者腺体切除时间分别为(50.0±6.9)、(39.9±6.6) min,均短于传统组的(82.0±14.4)、(73.1±14.5) min;超声刀组甲状腺全切除术、甲状腺次全切除术患者术中出血量分别为(18.7±10.9)、(17.7±9.3) ml,均少于传统组的(41.9±15.6)、(42.2±14.6) ml;超声刀组甲状腺全切除术、甲状腺次全切除术患者术后引流量分别为(40.7±11.7)、(42.7±14.5) ml,均少于传统组的(53.9±17.5)、(61.8±22.9) ml,差异均有统计学意义(P＜0.01).两组术后暂时性甲状旁腺功能低下、暂时性喉返神经麻痹发生情况比较差异无统计学意义(P＞0.05).结论 精细化被膜解剖技术的甲状腺手术中应用超声刀安全、可靠,具有手术时间、术中出血量、术后引流量明显减少的优势,可在临床中推广应用.
目的 探討甲狀腺精細化被膜解剖技術中超聲刀的應用體會,分析其安全性和療效.方法 選擇應用超聲刀對血管進行骨骼化為覈心的精細化被膜解剖技術的甲狀腺手術患者135例(超聲刀組),併選擇應用傳統手術器械的精細化被膜解剖技術的甲狀腺手術患者140例(傳統組).觀察比較兩組的腺體切除時間、術中齣血量、術後引流量及術後併髮癥髮生情況.結果 兩組患者均痊愈齣院.超聲刀組甲狀腺全切除術、甲狀腺次全切除術患者腺體切除時間分彆為(50.0±6.9)、(39.9±6.6) min,均短于傳統組的(82.0±14.4)、(73.1±14.5) min;超聲刀組甲狀腺全切除術、甲狀腺次全切除術患者術中齣血量分彆為(18.7±10.9)、(17.7±9.3) ml,均少于傳統組的(41.9±15.6)、(42.2±14.6) ml;超聲刀組甲狀腺全切除術、甲狀腺次全切除術患者術後引流量分彆為(40.7±11.7)、(42.7±14.5) ml,均少于傳統組的(53.9±17.5)、(61.8±22.9) ml,差異均有統計學意義(P＜0.01).兩組術後暫時性甲狀徬腺功能低下、暫時性喉返神經痳痺髮生情況比較差異無統計學意義(P＞0.05).結論 精細化被膜解剖技術的甲狀腺手術中應用超聲刀安全、可靠,具有手術時間、術中齣血量、術後引流量明顯減少的優勢,可在臨床中推廣應用.
목적 탐토갑상선정세화피막해부기술중초성도적응용체회,분석기안전성화료효.방법 선택응용초성도대혈관진행골격화위핵심적정세화피막해부기술적갑상선수술환자135례(초성도조),병선택응용전통수술기계적정세화피막해부기술적갑상선수술환자140례(전통조).관찰비교량조적선체절제시간、술중출혈량、술후인류량급술후병발증발생정황.결과 량조환자균전유출원.초성도조갑상선전절제술、갑상선차전절제술환자선체절제시간분별위(50.0±6.9)、(39.9±6.6) min,균단우전통조적(82.0±14.4)、(73.1±14.5) min;초성도조갑상선전절제술、갑상선차전절제술환자술중출혈량분별위(18.7±10.9)、(17.7±9.3) ml,균소우전통조적(41.9±15.6)、(42.2±14.6) ml;초성도조갑상선전절제술、갑상선차전절제술환자술후인류량분별위(40.7±11.7)、(42.7±14.5) ml,균소우전통조적(53.9±17.5)、(61.8±22.9) ml,차이균유통계학의의(P＜0.01).량조술후잠시성갑상방선공능저하、잠시성후반신경마비발생정황비교차이무통계학의의(P＞0.05).결론 정세화피막해부기술적갑상선수술중응용초성도안전、가고,구유수술시간、술중출혈량、술후인류량명현감소적우세,가재림상중추엄응용.
Objective To introduce the clinical experience and investigate the significance and safety of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy.Methods A retrospective analysis was performed on 275 patients who underwent thyroidectomy among which 135 patients were treated by capsular dissection technique and harmonic scalpel (harmonic scalpel group),the other 140 patients were treated by electric knife and traditional ligation (traditional group).The thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications were compared between two groups.Results In harmonic scalpel group,the thyroidectomy operative time of total thyroidectomy and subtotal thyroidectomy was significantly shorter than that in traditional group [(50.0±6.9) min vs.(82.0± 14.4) min,(39.9±6.6) min vs.(73.1 ± 14.5) min](P＜0.01).The intraoperative bleeding volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(18.7 ± 10.9) ml vs.(41.9 ± 15.6) ml,(17.7 ± 9.3) ml vs.(42.2 ± 14.6) ml] (P ＜ 0.01).The postoperative drainage volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(40.7 ± 11.7) ml vs.(53.9 ± 17.5) ml,(42.7 ± 14.5) ml vs.(61.8 ±22.9) ml](P＜0.01).The rate of temporary hypoparathyroidism and temporary recurrent laryngeal nerve palsy had no significant difference between two groups (P ＞ 0.05).Conclusions Application of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy can significantly reduce thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications.Harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy should be widely used.
