摘要
目的分析甲状腺外科手术中传统术式与低领小弧形切口的应用效果,探讨治疗该病的有效术式。方法选取武汉市普仁医院2017年10月到2018年10月收治的86例甲状腺外科手术患者,分为传统组和微创组,各43例,传统组应用传统术式治疗,微创组应用低领小弧形切口治疗,对比两组患者的术中情况(手术时间、出血量、切口长度)、术后情况(疼痛程度、住院时间)、甲状旁腺素和血清钙水平、并发症发生情况(切口皮下结节、切口粘连、低钙血症、甲状腺功能减退、喉返神经损伤)、切口美观程度。结果微创组患者的手术时间、术中出血量以及切口长度均少于传统组,且术后疼痛程度评分与住院时间均小于传统组,差异均有统计学意义(t=18.963、15.843、3.350、18.943、3.443,均P<0.05);两组患者术后的甲状旁腺素和血清钙水平均较术前有所降低,但微创组降低幅度小于传统组,差异有统计学意义(t=4.310、13.160,P<0.05);微创组患者的并发症发生率(9.3%)显著低于传统组(27.8%)(χ^2=4.914,P<0.05);微创组患者切口美观程度优于传统组(χ^2=12.797,P=0.002)。结论甲状腺外科手术中低领小弧形切口的应用效果显著,具有手术时间短、出血量少、切口长度小、术后疼痛轻、住院时间短、并发症少等优势,且对甲状旁腺素和血清钙水平的影响较小,术后美观程度高,值得临床推行。
Objective To compare the effect of traditional operation and small arc incision with low collar in thyroidectomy,and to explore the effective operation for this disease.Methods Eightysix patients with thyroid surgery admitted to Puren Hospital of Wuhan City from October 2017 to October 2018 were divided into traditional group and minimally invasive group,with 43 cases in each group.The traditional group was treated by traditional operation,while the minimally invasive group by low-collar small arc incision.The two groups were compared in intraoperative conditions (operation time,bleeding volume, incision),incision length,postoperative condition (degree of pain,length of hospital stay),parathyroid hormone and serum calcium level,complications (incision subcutaneous nodules,incision adhesion, hypocalcemia,hypothyroidism,recurrent laryngeal nerve injury),and incision aesthetic level.Results The operation time,bleeding volume and incision length of the minimally invasive group were less than those of the traditional group,and the pain score and hospitalization time of the minimally invasive group were smaller than those of the traditional group (t=18.963,15.843,3.350,18.943,3.443,all P<0.05).The levels of parathyroid hormone and serum calcium in the two groups were lower than those before operation,but the minimally invasive group decreased less (t=4.310、13.160;both P<0.05).The incidence of complications in the minimally invasive group (9.3%) was lower than that in the traditional group (27.8%) and the difference was significant (χ^2=4.914,P<0.05);the aesthetic degree of incision in the minimally invasive group was better than that in the traditional group (χ^2=12.797,P=0.002).Conclusions The application effect of low collar small arc incision in thyroidectomy is remarkable,which has the advantages of shorter operation time,less bleeding,smaller incision length,slighter postoperative pain,shorter hospitalization time and fewer complications.It also has less influence on parathyroid hormone and serum calcium levels,good postoperation course,and worthy of clinical implementation.
作者
尹兴锋
江帆
Yin Xingfeng;Jiang Fan(Department of Surgery,Wuhan City Puren River Bank Hospital,Wuhan 430012,China;Department of Hepatobiliary Surgery,Puren Hospital of Wuhan City,Wuhan 430081,China)
出处
《中华普通外科学文献（电子版）》
2019年第3期239-242,共4页
Chinese Archives of General Surgery(Electronic Edition)
基金
武汉市卫生和计划生育委员会科研项目(WX18D37)
关键词
甲状腺
外科手术
低领小弧形切口
治疗应用
比较
Thyroid gland
Surgical procedures,operative
Low collar small arc incision
Therapeutic uses
Comparison
