超声刀在甲状腺再次手术粘连分解中的应用  

Application of Ultrasonic Knife in Dissociating the Adhesion after the Reoperation of Thyroid Gland

作　　者：谭建中[1] 黄程[1] 刘命文[1] 方亮[1] 张洪武 余子牛[1] 

机构地区：[1]湖南省湘潭市第一人民医院肿瘤外科,湖南湘潭411101 [2]湖南省湘潭中心医院,湖南湘潭411100

出　　处：《医学临床研究》2011年第6期1127-1129,共3页Journal of Clinical Research

摘　　要：【目的】应用超声刀行甲状腺再次手术，研究术中粘连发生的情况，总结超声刀的应用价值。【方法】收集2003年12月至20lO年11月间本院完成的36例超声刀甲状腺再次手术病例资料，对其粘连记录进行整理、分析并作出归纳总结。【结果136例气管前区均发生粘连，其中轻度粘连7例，重度粘连29例；甲状腺表面区轻度粘连13例（19侧），重度粘连28例（47侧）；甲状腺上极区轻度粘连10例（20侧），重度粘连5例（10侧）；甲状腺下极区重度粘连5例（10侧）；甲状腺外侧区轻度粘连16例（28侧），无重度粘连。【结论】甲状腺再次手术严重粘连主要发生在气管前区、甲状腺表面区；既往有二次手术史者粘连更为明显；甲状腺外侧区粘连较轻；应用超声刀对粘连进行处理效果显著。[Objective] To explore the application of ultrasonic knife in the reoperation of thyroid gland and the incidence of the intraoperative adhesion, and to summarize the application value of ultrasonic knife. [Methods] Thirty six cases undergoing the reoperation of thyroid gland by using ultrasonic knife in our hospital from December 2003 to November 2010 were collected. The records of the adhesion were analyzed and summarized. [Results] The adhesion occurred in the front area of trachea of all the 36 cases, of which 7 cases were mild adhesion and 29 cases were severe adhesion. Mild adhesion in the surface area of thyroid gland occurred in 13 cases（19 sides） and severe adhesion occurred in 28 cases（47 sides）. Mild adhesion in the area of superior pole occurred in 10 cases（20 sides） and severe adhesion occurred in 5 cases（10 sides）. Mild adhesion in the area of inferior pole occurred in 16 cases（28 sides） and severe adhesion and no severe adhesion occurred. [Conclusion] The severe adhesion after the reoperation of thyroid gland mainly happens in the front area of tra- chea and the surface area of thyroid gland, and it is more obvious for patients with the history of two or more thyroid surgery. The adhesion in the outside area of thyroid is mild. Ultrasonic knife for dissociating the adhesion has significant effect.

关 键 词：甲状腺切除术 再手术 超声疗法 

分 类 号：R651.3[医药卫生—外科学]