内镜甲状腺手术皮下分离面积对手术参数影响研究  

Influence of subcutaneous dissection area on the surgical indexes of endoscopic thyroidectomy

作　　者：张伟[1] 仇明[1] 单成祥[1] 刘晟[1] 江道振[1] 郑向民[1] 沈宏亮[1] 

机构地区：[1]第二军医大学附属长征医院普外三科,上海200003

出　　处：《中国实用外科杂志》2013年第9期778-780,共3页Chinese Journal of Practical Surgery

摘　　要：目的分析胸乳径路内镜甲状腺手术皮下分离面积大小对手术技术参数和效果的影响。方法 2011年9月至2011年12月第二军医大学附属长征医院将接受内镜甲状腺手术的病人随机分为两组:胸乳径路标准分离组和乳腺切口胸壁径路有限分离组,对比分析两种手术方式在手术时间、出血量、切口长度、术后疼痛和引流量的差异。结果标准组皮下分离面积显著>有限分离组[(137.07±26.28)cm2vs.(92.07±17.41)cm2,P<0.05]。但两组在手术时间、出血量、切口长度差异无统计学意义。术后疼痛[VAS(3.93±1.94)vs(.4.13±1.06),P=0.729]和引流量[(124.00±28.98)mL vs(.109.00±27.46)mL,P=0.327]组间差异无统计学意义。结论内镜甲状腺手术皮下分离面积并非术后疼痛的主要原因,注重分离的正确层面有助于降低创伤。Objective To analyze the influence of subcutaneous dissection area on surgical indexes and results of breast approach endoscopic thyroidectomy. Methods Patients underwent endoscopic thyroidectomy between September 2011 and December 2011 in Changzheng Hospital Affiliated to Second Military Medical University were randomized allotted into standard dissection group and limited dissection group. Operative duration, blood loss, total length of incisions, postoperative pain and drainage volume were compared between two groups. Results Subcutaneous dissection area was significantly larger in standard group than that in limited dissection group [ （137.07±26.28）cm^2 vs. （92.07 ± 17.41 ）cm^2, P 〈 0.05 ]. But there was no significant difference in operative duration, blood loss and length of incisions between two groups. There was also no significant difference in postoperative pain （VAS （3.93±1.94） vs. （4.13± 1.06） , P=0.729） and drainage volume （124.00± 28.98） mL vs. （109.00± 27.46） mL, P=0.327） between two groups. Conclusion Subcutaneous dissection area of endoscopic thyroidectomy is not the influential factor contributing to postoperative pain. Getting into the right dissection plane should be emphasized.

关 键 词：内镜 甲状腺切除术 皮下分离面积 

分 类 号：R6[医药卫生—外科学]