摘要
目的探讨超声刀在开放性甲状腺手术中的疗效及临床应用价值。方法回顾性分析2014年1月至2016年12月在北京市房山区中医医院外科完成的甲状腺手术治疗患者132例,根据手术方法分为两组,超声刀组64例(超声刀甲状腺手术),传统组68例(传统甲状腺手术),比较两组患者的切口长度、手术时间、术中出血量、术后24 h引流量、住院时间、并发症发生情况。结果超声刀组的手术时间(43.68±10.56 min)短于传统组(79.57±16.97 min),术中出血量(超声刀组:19.16±8.73 ml,传统组:48.83±15.04 ml)、术后24 h引流量(超声刀组:11.56±5.17 ml,传统组:34.29±6.89 ml)均较传统组少,超声刀组术后的住院时间(5.56±1.23 d)也短于传统组(8.96±1.67 d)(P<0.05);而超声刀组(6.6±0.5 cm)和传统组的刀口长度(7.4±0.8 cm)比较差异无统计学意义(P>0.05)。超声刀组的暂时性甲状旁腺损伤、一过性饮水呛咳、一过性声音嘶哑的发生率均明显低于传统组(P<0.05),而超声刀组永久性甲状旁腺损伤、永久性声音嘶哑发生率与传统组比较差异无统计学意义(P>0.05)。结论超声刀应用于开放性甲状腺手术,有手术切口小、手术操作简单、手术时间短、手术创伤小、出血量少等优点,明显优于传统手术方法,具有良好的临床应用价值。
Objective To investigate the use of ultrasonic scalpel in open thyroid surgery and its clinical value. Methods One hundred and thirty two cases were treated with subtotal thyroidectomy surgery in surgery department of Beijing Fangshan District Chinese Medicine hospital from January 2015 to January 2016,including 64 cases undergoing ultrasonic scalpel thyroidectomy and 68 cases receiving conventional thyroidectomy. The length of incision,the operation time,bleeding volume,postoperative draining volume and postoperative complication rate between two groups were compared. Results Compared with conventional thyroidectomy,use of ultrasonic scalpel in the open thyroid surgery could shorten the incision length（ 6. 6 ± 0. 5 cm vs. 7. 4 ± 0. 8 cm）,decrease the operation time（ 43. 68 ± 10. 56 min vs. 79. 57 ± 16. 97 min）,intraoperative blood loss（ 19. 16 ± 8. 73 ml vs. 48. 83 ± 15. 04 ml） and postoperative drainage volume（ 11. 56 ± 5. 17 ml） vs（ 34. 29 ± 6. 89） ml〗,with all statistical significant differences（ P〈0. 05）. The incidence of temporary parathyroid injury,transient cough,transient hoarseness,and incidence of hoarseness in the ultrasonic scalpel group were lower than those in the conventional surgery group（ P〈0. 05）. However,there was no significant difference in persistent parathyroid injury,persistent hoarseness between the two groups（ P〉0. 05）. Conclusion In open thyroid operation,compared with the traditional method,the ultrasonic scalpel operation has some advantages,including small surgical incision,simple surgical operation,short operation time,less surgical trauma,less bleeding. The ultrasonic scalpel operation has good clinical application value.
作者
白建云
张菁
王旭红
毛廷森
BAI Jian - yun;ZHANG Jing;WANG Xu - hong;et al.(Department of General Surgery, Beijing Fangshan District Chinese Medicine Huspital, Beijing 102400, China;Department of Endocrinology , Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China)
出处
《临床和实验医学杂志》
2018年第12期1315-1317,共3页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金(编号:81771860)
北京市通州区卫计委整合医学课题(编号:KJ2016CX029)
关键词
开放性甲状腺手术
超声刀
外科
Ultrasonic scalpel
Open thyroid operation
Surgery
