颈前带状肌纵切口与颈白线切口在甲状腺手术中应用的效果评价  

The effect evaluation of cervical strap muscles longitudinal incision and linea alba cervicalis incision in thyroid surgery

作　　者：吴志广 

机构地区：[1]浙江省三门县人民医院肿瘤外科,317100

出　　处：《中国医师进修杂志》2011年第17期26-28,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价颈前带状肌纵切口与颈白线切口在甲状腺手术中应用的优、缺点。方法回顾性分析91例行甲状腺手术患者的临床资料，按照随机数字表法分为两组，观察组46例采用颈前带状肌纵切口，对照组45例采用颈白线切口，两组麻醉均采用颈丛神经阻滞。比较两组患者的手术效果。结果两组患者的总手术时间、术中出血量和术后并发症比较差异均无统计学意义（P〉0．05）；观察组在甲状腺上极、下极及外侧的暴露效果评分[（3．88±0．32）、（3．68±0．46）、（3．55±0．47）分]明显高于对照组[分别为（2．15±0．22）、（2．18±0．42）、（2．18±0．39）分]（P〈0．01），但在甲状腺峡部的暴露效果评分[（2．31±0．39）分]明显低于对照组[（3．48±0．52）分]（P〈0．01）。观察组SF-36评分总分[（77．1±7．3）分]明显高于对照组[（66．4±6-8）分]（P〈0．05）。结论颈前带状肌纵切口与颈白线切口在甲状腺手术中应用效果均满意，但两种切口暴露效果不同，手术时需根据患者具体情况选择适合的手术入路。Objective To evaluate the advantages and disadvantages of cervical strap muscles longitudinal incision and linea alba cervicalis incision in thyroid surgery. Methods The clinical data of 91 patients with thyroid surgery were retrospectively analyzed. They were divided into two groups by random digits table, 46 patients with cervical strap muscles longitudinal incision as the observation group, 45 patients with linea alba cervicalis incision as the control group, the surgery effect of two groups was compared. Results The operative time, blood loss and postoperative complications between the two groups, the differences were not statistically significant （P 〉 0.05 ）. Compared with control group, the exposure evaluation scores in the upper pole [ （3.88 ± 0.32） points vs. （2.15 ＋ 0.22） points ], under pole [ （3.68 ± 0.46） points vs. （2.18 ±0.42） points] and lateral side [（3.55 ±0.47） points vs. （2.18 ±0.39） points] of thyroid in observation group were significantly better （P 〈 0.01 ）, but the exposure effect scores in thyroid gorge were significantly lower [ （2.31 ± 0.39） points vs. （3.48 ± 0.52） points ] （P 〈 0.01 ）, SF-36 score was better [（77.1 ± 7.3） points vs. （66.4 ± 6.8） points]（P〈 0.05）. Conclusion The effects of cervical strap muscles longitudinal incision and linea alba cervicalis incision in thyroid surgery are satisfactory, but the exposure effect of two incision are different, thus it is required to choose the applications according to the conditions of patients.

关 键 词：甲状腺切除术 颈前带状肌 颈白线 

分 类 号：R653[医药卫生—外科学]