选择低位小切口行甲状腺癌选择性淋巴结清扫  

Low small incision in total thyroidectomy and selective neck lymphnode dissection

作　　者：曹磊[1] 贺青卿[1] 庄大勇[1] 郑鲁明[1] 范子义[1] 周鹏[1] 朱见[1] 

机构地区：[1]济南军区总医院甲状腺乳腺外科,济南250031

出　　处：《山东大学耳鼻喉眼学报》2013年第2期56-59,63,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：中国博士后科学基金第三批特别资助项目(201003759);济南军区总医院院长基金资助(2011M03)

摘　　要：目的探讨超声刀联合自动拉钩辅助低位领式小切口行甲状腺全切除+选择性淋巴结清扫术的可行性。方法选择甲状腺癌患者124例,随机分为实验组62例和对照组62例,实验组采用超声刀联合自动拉钩辅助低位领式小切口行甲状腺全切除+选择性淋巴结清扫术;对照组采用低位领式切口行甲状腺全切除+选择性淋巴结清扫术。对两组手术住院时间、肿瘤大小、切口长度、手术时间、术中出血量、手术操作者人数、术后引流量、术后引流时间,以及术前、术后甲状旁腺素、血清钙、血清磷、切除淋巴结数量及术后并发症进行比较。结果实验组手术时间、手术操作者人数、切口长度、术中出血量均少于对照组(P<0.05);其余指标差异无统计学意义(P>0.05)。结论超声刀联合自动拉钩辅助低位领式小切口行甲状腺全切除+选择性淋巴结清扫术治疗方法可行,具有术时短、手术操作者人数少、术中出血量少、切口小的优势。Objective To explore the feasibility of harmonic focus scalpel combined with Frankfurt automatic retractor auxiliary low collar small incision in total thyroidectomy and selective neck lymphnode dissection. Methods 124 pa- tients with thyroid cancer were randomly divided into two groups： the experimental group of 62 patients with harmonic focus scalpel combined with a low collar small incision assisted with a Frankfurt automatic retractor, and the control group of 62 patients with a low collar incision. Two groups were compared by hospitalization time, tumor size, incision length, operative time, blood loss, number of operators, post-operative drainage, post-operative drainage time, pre-op- erative and post-operative parathyroid hormone, serum calcium, serum phosphorusvalue, the number of resected lymph nodes and post-operative complications. Results Compared to the control group, it was statistically decreased in oper- ative time, number of operators, incision length and blood loss in the operation in the experimental group （ P 〈 0.05 ）. However, other clinical indicators were not significantly different between the two groups （ P 〉 0.05 ）. Conclusion Utility of Harmonic focus scalpel combined with Frankfurt automatic retractor auxiliary low collar small incision under- went total thyroidectomy and selective neck lymph node dissection is feasible, and it has the advantages of shorter opera- tive time, smaller number of operators, less blood loss and smaller incision.

关 键 词：甲状腺癌 Harmonic FOCUS超声刀 Frankfurt自动拉钩 淋巴结清扫术 低位小切口 

分 类 号：R736.1[医药卫生—肿瘤]