中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2015年
12期
93-96
,共4页
开放性甲状腺手术%Focus超声刀%甲状旁腺功能
開放性甲狀腺手術%Focus超聲刀%甲狀徬腺功能
개방성갑상선수술%Focus초성도%갑상방선공능
Open hypothyroid operation%Focus ultrasound knife%Parathyroid function
目的：探讨Focus超声刀在开放性甲状腺手术中的应用及对甲状旁腺功能的影响。方法选择2012年6月~2014年6月天台县人民医院普外科收治的80例甲状腺良性肿瘤患者，随机分为观察组与对照组，观察组采用Focus超声刀进行开放性甲状腺手术，对照组采用传统电刀进行开放性甲状腺手术治疗。观察两组患者切口长度、手术时间、术中出血量及术后引流量。观察两组患者术后血钙水平，比较两种手术方式对术后患者甲状旁腺功能的影响。结果观察组患者手术切口长度[（3.67±1.02）cm]、手术时间[（58.74±10.76）min]、术中出血量[（20.53±5.12）mL]及术后引流量[（38.79±8.73）mL]均明显少于对照组[（5.68±1.42）cm、（72.16±12.33）min、（58.22±13.12）mL、（85.42±15.14）mL]，差异有统计学意义（t =2.37、2.42、5.34、6.02，P<0.05或P<0.01）；术后3 d 观察组血钙和甲状旁腺激素水平[（1.93±0.23）mmol/L、（34.16±9.75）ng/L]、对照组[（1.81±0.20）mmol/L、（25.46±7.14）ng/L]均较术前[（2.31±0.15）mmol/L、（44.15±10.35）ng/L，（2.28±0.17）mmol/L、（44.61±11.64）ng/L]明显降低，差异有统计学意义（t =2.14、4.06、3.68、5.04，P<0.05或P<0.01），且对照组低于观察组，差异有统计学意义（t =2.35、2.08，P<0.05）；观察组患者甲状旁腺功能损害发生率（5.0%）低于对照组（20.0%），差异有统计学意义（χ2=4.11，P<0.05）。结论开放性甲状腺手术中应用Focus超声刀具有手术切口小、手术时间短、术中出血少、术后恢复快等优点，同时还能在术中有效地保护甲状旁腺，减少甲状旁腺功能损害的发生，是一种安全有效的手术方式。
目的：探討Focus超聲刀在開放性甲狀腺手術中的應用及對甲狀徬腺功能的影響。方法選擇2012年6月~2014年6月天檯縣人民醫院普外科收治的80例甲狀腺良性腫瘤患者，隨機分為觀察組與對照組，觀察組採用Focus超聲刀進行開放性甲狀腺手術，對照組採用傳統電刀進行開放性甲狀腺手術治療。觀察兩組患者切口長度、手術時間、術中齣血量及術後引流量。觀察兩組患者術後血鈣水平，比較兩種手術方式對術後患者甲狀徬腺功能的影響。結果觀察組患者手術切口長度[（3.67±1.02）cm]、手術時間[（58.74±10.76）min]、術中齣血量[（20.53±5.12）mL]及術後引流量[（38.79±8.73）mL]均明顯少于對照組[（5.68±1.42）cm、（72.16±12.33）min、（58.22±13.12）mL、（85.42±15.14）mL]，差異有統計學意義（t =2.37、2.42、5.34、6.02，P<0.05或P<0.01）；術後3 d 觀察組血鈣和甲狀徬腺激素水平[（1.93±0.23）mmol/L、（34.16±9.75）ng/L]、對照組[（1.81±0.20）mmol/L、（25.46±7.14）ng/L]均較術前[（2.31±0.15）mmol/L、（44.15±10.35）ng/L，（2.28±0.17）mmol/L、（44.61±11.64）ng/L]明顯降低，差異有統計學意義（t =2.14、4.06、3.68、5.04，P<0.05或P<0.01），且對照組低于觀察組，差異有統計學意義（t =2.35、2.08，P<0.05）；觀察組患者甲狀徬腺功能損害髮生率（5.0%）低于對照組（20.0%），差異有統計學意義（χ2=4.11，P<0.05）。結論開放性甲狀腺手術中應用Focus超聲刀具有手術切口小、手術時間短、術中齣血少、術後恢複快等優點，同時還能在術中有效地保護甲狀徬腺，減少甲狀徬腺功能損害的髮生，是一種安全有效的手術方式。
목적：탐토Focus초성도재개방성갑상선수술중적응용급대갑상방선공능적영향。방법선택2012년6월~2014년6월천태현인민의원보외과수치적80례갑상선량성종류환자，수궤분위관찰조여대조조，관찰조채용Focus초성도진행개방성갑상선수술，대조조채용전통전도진행개방성갑상선수술치료。관찰량조환자절구장도、수술시간、술중출혈량급술후인류량。관찰량조환자술후혈개수평，비교량충수술방식대술후환자갑상방선공능적영향。결과관찰조환자수술절구장도[（3.67±1.02）cm]、수술시간[（58.74±10.76）min]、술중출혈량[（20.53±5.12）mL]급술후인류량[（38.79±8.73）mL]균명현소우대조조[（5.68±1.42）cm、（72.16±12.33）min、（58.22±13.12）mL、（85.42±15.14）mL]，차이유통계학의의（t =2.37、2.42、5.34、6.02，P<0.05혹P<0.01）；술후3 d 관찰조혈개화갑상방선격소수평[（1.93±0.23）mmol/L、（34.16±9.75）ng/L]、대조조[（1.81±0.20）mmol/L、（25.46±7.14）ng/L]균교술전[（2.31±0.15）mmol/L、（44.15±10.35）ng/L，（2.28±0.17）mmol/L、（44.61±11.64）ng/L]명현강저，차이유통계학의의（t =2.14、4.06、3.68、5.04，P<0.05혹P<0.01），차대조조저우관찰조，차이유통계학의의（t =2.35、2.08，P<0.05）；관찰조환자갑상방선공능손해발생솔（5.0%）저우대조조（20.0%），차이유통계학의의（χ2=4.11，P<0.05）。결론개방성갑상선수술중응용Focus초성도구유수술절구소、수술시간단、술중출혈소、술후회복쾌등우점，동시환능재술중유효지보호갑상방선，감소갑상방선공능손해적발생，시일충안전유효적수술방식。
Objective To discuss the application of Focus ultrasound knife on open hypothyroid operation and its influence on parathyroid function. Methods From June 2012 to June 2014, at Department of General Surgery, People's Hospital of Tiantal County, 80 patients with benign tumor of thyroid were selected and divided into observation group and control group randomly. The patients in observation group were given open hypothyroid operations with Focus ultrasound knife, while the patients in control group were given open hypothyroid operations with traditional electric scalpel. The length of incision, surgery time, intra-operative bleeding and postoperative dralnage of two groups were observed. Postoperative blood calcium levels of two groups were observed, and the influence on parathyroid function of postoperative patients in two operation ways were compared. Results The length of incision [(3.67±1.02)cm], surgery time [(58.74±10.76) min], intra-operative bleeding [(20.53±5.12) mL] and postoperative dralnage [(38.79±8.73) mL] in observation group were less than those in control group [(5.68±1.42) cm, (72.16±12.33) min, (58.22±13.12) mL, (85.42±15.14) mL], the differences were statistically significant (t = 2.37, 2.42, 5.34, 6.02, P < 0.05 or P < 0.01). After operation 3 d, calcium serum and parathormone levels of patients in in observation group [(1.93±0.23) mmol/L, (34.16±9.75) ng/L] and those in control group [(1.81±0.20) mmol/L, (25.46±7.14) ng/L] were less than those before the operation [(2.31±0.15) mmol/L, (44.15±10.35) ng/L, (2.28±0.17) mmol/L, (44.61±11.64) ng/L], the differences were statistically significant (t=2.14, 4.06, 3.68, 5.04, P<0.05 or P<0.01). and these in control group were less than those in observation group, the differences were statistically significant (t = 2.35, 2.08, P < 0.05). The incidence of parathyroid function damage in observation group (5.0%) was than lower that in control group (20.0%), the difference was statistically significant (χ2 = 4.11, P < 0.05). Conclusion The application of Focus ultrasound knife on Open hypothyroid operation can achieve favorable effect with tiny incision, short operation time, small amount of intra-operative bleeding and fast postoperative recovery, meanwhile it can protect parathyroid glands during the operation and reduce the incidence of parathyroid function damage, it is a safe and effective operation method.
