甲状腺再次手术胸锁乳突肌内侧缘入路与颈白线入路手术方式的比较  

Comparison between secondary thyroidectomy by lateral approach and central compartment

作　　者：王毅[1] 杜嘉林[1] 吴泽宇[1] 区金锐[1] 简志祥[1] 

机构地区：[1]广东省人民医院普外科,广州市510080

出　　处：《实用医学杂志》2013年第7期1109-1111,共3页The Journal of Practical Medicine

摘　　要：目的:探讨甲状腺再次手术胸锁乳突肌内侧缘入路的可行性及优势。方法:将145例甲状腺再次手术患者随机分为两组,分别经两种入路实施甲状腺手术:外侧入路组(n=65)和正中入路组(n=80)。结果:外侧入路组手术总时间[外侧入路组70(30～265)min,正中入路组87(40～180)min,Z=-2.915,P=0.004]及显露甲状腺时间[外侧入路组(4.0±1.5)min,正中入路(5.0±2.0)min,t=-3.312,P=0.001]比正中入路组短。外侧入路组术中平均出血量明显少于正中入路组[外侧入路组10(5～100)mL,正中入路组30(5～500)mL,Z=-3.095,P=0.002]。两组患者术后住院天数无显著统计学差异(Z=-0.256,P=0.798)。结论:再次甲状腺手术采用外侧入路可获得相对较清晰的解剖层次,适用于大部分甲状腺再次手术。Objective To explore the feasibility and advantage of secondary thyroidectomy by lateral approach. Methods 145 secondary thyroidectomies were performed in our department from January 2009 to April 2012. 145 patients were randomised to accept thyroidectomy with lateral approach（n = 65） or central compartment（n = 80）. Results The group of lateral approach has less operative time [ 70 （30 ~ 265）min vs. 87 （40 ~ 180） min, Z = -2.915,P = 0.004] and the time of exposing thyroid [（4.0 ± 1.5） min vs. （5.0 ~ 2.0） min, t = -3.312,P = 0.001 ] than that in the group of central compartment. There was no difference between two groups in postoperative hospital stay（Z = -0.256,P = 0.798）. Conclusion Thyroidectomy by lateral approach is suitable for most patients who need secondary thyroidectomy since it can provide clear anatomical structures.

关 键 词：甲状腺切除术 手术入路 再次手术 

分 类 号：R653[医药卫生—外科学]