超声刀结合保留背膜解剖法在甲状腺切除术中的应用  

Application of ultrasonically activated scalpel combined keeping notacoria in thyroidectomy

作　　者：许群英[1] 洪天姿[1] 杨波[1] 王灿阳[1] 

机构地区：[1]晋江市医院肿瘤外科,福建晋江362200

出　　处：《外科理论与实践》2012年第5期486-489,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:探讨超声刀结合保留背膜解剖法在甲状腺腺叶全切除手术中的操作技巧,及对喉返神经与甲状旁腺的保护效果。方法:对2009年2月至2012年3月144例甲状腺腺叶切除术均采用保留背膜解剖法,其中超声刀应用组72例与传统组72例的临床资料进行回顾性分析,通过手术时间、术中出血量、术后引流量、术后并发症等临床资料进行统计学分析。结果:应用超声刀结合保留背膜解剖法在甲状腺切除术中最大限度地原位保留了甲状旁腺,实现其功能的保留,喉返神经显露率达99%。同时超声刀的应用对术中出血量、手术时间均优于传统手术组,对术后并发症增加无统计学差异。结论:超声刀结合保留背膜解剖法在甲状腺腺叶全切除术中的应用能最大限度保留甲状旁腺功能,降低喉返神经、甲状旁腺损伤率;同时减少了出血量,缩短了手术时间。Objective To investigate the operation technique of ultrasonically activated scalpel （UAS） combined with the procedure keeping notacoria in thyroidectomy and to evaluate the benefits of the protection of recurrent laryngeal nerve and parathyroid gland. Methods From Feb 2009 to Mar 2012, the clinical data of 144 patients underwent thyroid lobectomy with the procedure keeping notacoria were analyzed. Seventy-two cases received UAS thyroid lobectomy, and the others by conventional method. The operation time, intraoperative bleeding volume, postoperative draining volume and postoperative mobidity between two groups were compared. Results The UAS method could keep the parathyroid gland in situ with function at the most. The recurrent laryngeal nerve was explored in 99% of the cases. The operation time, in- traoperative bleeding volume and the postoperative draining volume in the UAS group were significantly lower than that in the conventional group. There was no significantly difference in postoperative mobidity between the two groups. Conclusions Application of ultrasonically activated scalpel combined keeping notacoria in throid lobectomy could keep the function of parathyroid gland at the most, reduce the damage of recurrent laryngeal nerve and parathyroid gland. It was useful to reduce intraoperative bleed volume and the operation time.

关 键 词：超声刀 甲状腺 手术治疗 

分 类 号：R653[医药卫生—外科学]