甲状腺外被膜在预防甲状腺手术切口粘连中的作用  

Action of Thyroid Extra-tegument in Prevention of Operative Incision Adhesion of Thyroid

作　　者：徐宝庆 付振彬 刘瑞梅 

机构地区：[1]延寿县人民医院,黑龙江延寿150700

出　　处：《黑龙江医学》2006年第3期222-223,235,共3页Heilongjiang Medical Journal

摘　　要：目的探讨甲状腺手术后创面粘连的预防方法。方法将需要手术治疗的原发甲状腺机能亢进症患者随机分成A、B两组，每组50例。两组不同的手术处理方法是：A、B组在断舌骨下肌群时，保留附在甲状腺外被膜表面的一薄层肌纤维，其连同外被膜中线开后向两侧拉开，缝合切口前再牵回缝合。而B组舌骨下肌群及甲状腺外被膜完全横断，缝合切口时不缝合外被膜。两组患者都分别在术前及术后1—2年间做甲状腺彩色超声检查，以观察吞咽时气管和腺体与前方组织间的相对移动情况。结果两组术后甲状腺彩色超声情况是：A组不同步移动45例，同步移动有5例；B组分别有28例，22例。x^2=14．66，P〈0．01。显示两组间有显著差异。结论完全横断与不缝合外被膜组较保护与缝合外被膜组手术创面与前方组织容易发生粘连。Objective To discuss the preventive method of operative incision adhesion of thyroid. Methods The primary thyroidism patients who received operation were divided into two groups （50 cases per each）. Methods The group A was performed to preserve and separate in the middle of the thyroid extra - tegument when mutilation of infrahyoid muscles and suture it before closing incision. The group B was performed without preservation this membrane and suture before closing incision. The Doppler was taken to detected the situation of operative area as trachea and its anterior tissue and their motion relatively after 1- 2 years. Results The Doppler showed after operation in group A that there were 45 cases derangement motion and 5 cases timing motion, but in group B there were 28 cases DM and 22 cases TM with significant difference （ P 〈 0.01）. Conclusion The preservation of thyroid extra - tegument and suture before closing incision might prevent the adhesion of incision which better than that without suture.

关 键 词：普通外科学 甲状腺 甲状腺机能亢进症 手术方法 切口粘连 

分 类 号：R653[医药卫生—外科学]