腔镜胸骨前径路甲状腺手术后并发症的临床分析(附186例报告)  

Clinical analysis of postoperative complications in patients with endoscopic thyroidectomy via anterior chest:with a report of 186 cases

作　　者：刘海滨[1] 王文跃[1] 鲁瑶[1] 

机构地区：[1]卫生部中日友好医院,北京100029

出　　处：《腹腔镜外科杂志》2010年第6期444-446,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腔镜甲状腺术后各种并发症的发生率及防治经验。方法：回顾分析经胸骨前入路为186例患者行腔镜甲状腺切除术的临床资料,总结手术并发症的发生率及防治措施。结果：175例顺利完成手术,3例因快速切片报告为乳头状癌、8例因术中出血中转开放。手术时间50-180min,平均95min;发生暂时性喉返神经损伤2例,颈前皮下积液13例,颈前皮肤淤斑、红肿4例,颈前皮肤粘连3例,皮下气肿2例,术中大出血8例,颈胸皮肤紧张不适感5例,咽喉疼痛10例。结论：腔镜甲状腺手术安全可行,颈前皮下积液是最常见的并发症,发生率与手术范围及患者年龄有关,术中出血是中转开放最常见的原因。Objective：To explore the incidence rate and prevention actions of postoperative complications in patients with endoscopic thyroidectomy via anterior chest.Methods：Retrospective analysis was made on clinical data of 186 cases with laparoscopic thyroidectomy via anterior chest,the incidence rate and prevention actions of operative complication were summarized.Results：The laparoscopic thyroidectomy was successfully carried out in 175 cases.3 cases were converted into open surgery due to papillary carcinoma,8 cases were converted into open surgery due to bleeding.The operative time ranged from 50 to 180min（mean 95min）,recurrent laryngeal nerve temporary damage occurred in 2 cases,subcutaneous hydrops was found in 13 cases,skin ecchymosis and swell in 4 cases,skin adhesion at anterior chest in 3 cases,subcutaneous pneumoderma in 2 cases,serious bleeding during surgery in 8 cases,intense and discomfort of neck and thoracic skin in 5 cases,throat pain in 10 cases.Conclusions：Endoscopic thyroidectomy is a safe and effective method of thyroid surgery.subcutaneous hydrops is the most common complication.the incidence rate is connection with age and surgical extent.Intraoperatively serious bleeding is the most common reason for conversion to open surgery.

关 键 词：甲状腺疾病 甲状腺切除术 内窥镜检查 手术后并发症 

分 类 号：R653[医药卫生—外科学]