甲状腺全切除术技术改进临床应用分析  

Analysis of the clinical application of technical improvement of total thyroidectomy

作　　者：吴红伟[1] 王飞[1] 胡洪生[1] 方大正[1] 张桢[1] 周文波[1] 

机构地区：[1]湖北医药学院附属东风医院肝胆外科,湖北十堰442000

出　　处：《中国普通外科杂志》2011年第5期523-525,共3页China Journal of General Surgery

摘　　要：目的探讨改良式甲状腺全切除术的临床实用性及安全性。方法回顾性分析2009年5月—2010年12月,采用以"血管骨骼化移行凝闭离断法"为核心的血管处理、精细被膜解剖等系列技术改进方法进行甲状腺全切除术62例(甲组)的临床资料,并与2005年1月—2009年4月所行传统甲状腺全切除术81例(乙组)比较,对比2种手术方式在术后暂时性低钙、永久性低钙、暂时性声带麻痹、永久性声带麻痹的发生率的差异。结果甲组术后发生短暂性低钙血症及暂时性声带麻痹的比率(4.8%,3.2%)比乙组(14.8%,13.6%)明显降低(χ2=5.341,P=0.021;χ2=2.346,P=0.033),且没有发生永久性甲状旁腺功能低下和喉返神经永久性损伤的病例。结论改良式甲状腺全切除技术比传统甲状腺全切除术更安全、可靠。Objective To investigate the safety and clinical practice of a modified total thyroidectomy technique.Methods The clinical data of 62 patients undergoing total thyroidectomy with the modified technique which comprised a series of improvements including vascular management of ＂vessel skeletonized-carryover coagulation-vessel block＂,meticulous capsular dissection and en bloc excision（group A）,from May 2009 to December 2010,were retrospectively analyzed.The other 81 patients undergoing the traditional total thyroidectomy from January 2005 to April 2009 were used as a control group（group B）.The incidence of postoperative complications including temporary and permanent hypocalcemia,temporary and permanent vocal cord paralysis were compared between the two groups.Results No permanent hypoparathyroidism or permanent recurrent laryngeal nerve palsy occurred and the incidence rates of temporary hypocalcemia and temporary vocal cord paralysis were 4.8% and 3.2% in group A,which were significantly lower than those in group B（14.8%,13.6%,respectively）（χ2 =5.341,P=0.021;χ2 =2.346,P=0.033）.Conclusions Total thyroidectomy by modified procedure is safe and reliable compared with traditional total thyroidectomy.

关 键 词：甲状腺切除术/方法 血管骨骼化 对比研究 

分 类 号：R653.2[医药卫生—外科学]