中国当代医药
中國噹代醫藥
중국당대의약
China Modern Medicine
2015年
29期
26-28,32
,共4页
李小腾%林云%戴鹏%艾秋宝%张国然
李小騰%林雲%戴鵬%艾鞦寶%張國然
리소등%림운%대붕%애추보%장국연
甲状腺手术%甲状旁腺误切%甲状腺功能%精细被膜解剖法%淋巴示踪
甲狀腺手術%甲狀徬腺誤切%甲狀腺功能%精細被膜解剖法%淋巴示蹤
갑상선수술%갑상방선오절%갑상선공능%정세피막해부법%림파시종
Thyroid operation%Parathyroid cut by mistake%Thyroid function%Fine capsule anatomical method%Lymph tracer
目的：研究精细被膜解剖法联合纳米碳甲状腺淋巴示踪术在甲状腺次全切除术中的应用效果。方法以2013年5月~2015年5月我院收治的52例行甲状腺手术治疗的患者为研究对象，采用随机数字表法将其分为观察组26例和对照组26例。对照组患者行传统甲状腺全切除术治疗，观察组患者于甲状腺全切术中行精细被膜解剖法联合纳米碳甲状腺淋巴示踪术。观察统计两组患者的术中出血量、手术时间及术后住院天数，统计患者术中甲状旁腺误切及术后声音嘶哑的发生率；检测两组患者手术前后血清Ca2+及PTH的水平；统计甲状旁腺功能减退及低钙症状的发生率。结果两组平均术中出血量、手术时间、术后住院天数比较，差异无统计学意义(P>0.05)；观察组患者术中甲状旁腺误切及术后声音嘶哑的发生率依次为3.85%、7.69%，对照组依次为19.23%、23.08%，两组比较，差异有统计学意义(P<0.05)。术后第1、2、7天及术后1个月，观察组患者的平均血清Ca2+、PTH水平均高于对照组(P<0.05)。观察组患者甲状旁腺功能减退及低钙症状的发生率依次为19.23%、11.54%，对照组依次为38.46%、26.92%，差异有统计学意义(P<0.05)。结论在甲状腺手术中予以精细被膜解剖法联合纳米碳甲状腺淋巴示踪术能有效避免术中甲状旁腺误切，保护甲状腺功能。
目的：研究精細被膜解剖法聯閤納米碳甲狀腺淋巴示蹤術在甲狀腺次全切除術中的應用效果。方法以2013年5月~2015年5月我院收治的52例行甲狀腺手術治療的患者為研究對象，採用隨機數字錶法將其分為觀察組26例和對照組26例。對照組患者行傳統甲狀腺全切除術治療，觀察組患者于甲狀腺全切術中行精細被膜解剖法聯閤納米碳甲狀腺淋巴示蹤術。觀察統計兩組患者的術中齣血量、手術時間及術後住院天數，統計患者術中甲狀徬腺誤切及術後聲音嘶啞的髮生率；檢測兩組患者手術前後血清Ca2+及PTH的水平；統計甲狀徬腺功能減退及低鈣癥狀的髮生率。結果兩組平均術中齣血量、手術時間、術後住院天數比較，差異無統計學意義(P>0.05)；觀察組患者術中甲狀徬腺誤切及術後聲音嘶啞的髮生率依次為3.85%、7.69%，對照組依次為19.23%、23.08%，兩組比較，差異有統計學意義(P<0.05)。術後第1、2、7天及術後1箇月，觀察組患者的平均血清Ca2+、PTH水平均高于對照組(P<0.05)。觀察組患者甲狀徬腺功能減退及低鈣癥狀的髮生率依次為19.23%、11.54%，對照組依次為38.46%、26.92%，差異有統計學意義(P<0.05)。結論在甲狀腺手術中予以精細被膜解剖法聯閤納米碳甲狀腺淋巴示蹤術能有效避免術中甲狀徬腺誤切，保護甲狀腺功能。
목적：연구정세피막해부법연합납미탄갑상선림파시종술재갑상선차전절제술중적응용효과。방법이2013년5월~2015년5월아원수치적52례행갑상선수술치료적환자위연구대상，채용수궤수자표법장기분위관찰조26례화대조조26례。대조조환자행전통갑상선전절제술치료，관찰조환자우갑상선전절술중행정세피막해부법연합납미탄갑상선림파시종술。관찰통계량조환자적술중출혈량、수술시간급술후주원천수，통계환자술중갑상방선오절급술후성음시아적발생솔；검측량조환자수술전후혈청Ca2+급PTH적수평；통계갑상방선공능감퇴급저개증상적발생솔。결과량조평균술중출혈량、수술시간、술후주원천수비교，차이무통계학의의(P>0.05)；관찰조환자술중갑상방선오절급술후성음시아적발생솔의차위3.85%、7.69%，대조조의차위19.23%、23.08%，량조비교，차이유통계학의의(P<0.05)。술후제1、2、7천급술후1개월，관찰조환자적평균혈청Ca2+、PTH수평균고우대조조(P<0.05)。관찰조환자갑상방선공능감퇴급저개증상적발생솔의차위19.23%、11.54%，대조조의차위38.46%、26.92%，차이유통계학의의(P<0.05)。결론재갑상선수술중여이정세피막해부법연합납미탄갑상선림파시종술능유효피면술중갑상방선오절，보호갑상선공능。
Objective To study the application effect of fine capsule anatomical method combined with nano carbon thyroid lymph tracer technique in subtotal thyroidectomy surgery. Methods 52 patients with thyroid surgery from May 2013 to May 2015 of our hospital were selected.Patients were divided into observation group(n=26)and control group(n=26) according to random number table.Patients in control group were treated with traditional total thyroidectomy.Pa-tients in observation group were treated with fine capsule anatomical method combined with nano carbon thyroid lymph tracer technique during total thyroidectomy.Bloodloss,operative time and hospital stay were observed between two groups.The incidence of intraoperative parathyroid cut by mistake and postoperative hoarseness were counted.At the same time,before and after operation,the level of Ca2+ and PTH between two groups were tested.The incidence of hy-poparathyroidism and hypocalcemia were counted. Results There were no significantly difference between two groups in mean bloodloss,operative time and hospital stay(P>0.05).The incidence of intraoperative parathyroid cut by mistake and postoperative hoarseness in observation group was respectively 3.85% and 7.69%,in control group was respectively 19.23%and 23.08%,the difference between two groups was statistical significance(P<0.05).The frist,second,seventh days and 1 months after operation,the mean level of Ca2+ and PTH in observation group was higher than control group re-spectively (P<0.05).The incidence of hypoparathyroidism and hypocalcemia in observation group were respectively 19.23%and 11.54%,in control group were respectively 38.46% and 26.92%,the difference between two groups was sta-tistical significance (P<0.05). Conclusion During thyroid operation,fine capsule anatomical method combined with nano carbon thyroid lymph tracer technique can effectively avoid intraoperative parathyroid cut by mistake and protect the thyroid function.
