超声刀在开放性甲状腺手术中应用的前瞻性研究  

Use of harmonic scalpel in open thyroid surgery: a prospective study

作　　者：邱海江[1] 方孙阳[1] 吴志明[1] 陈福森[1] 陈江[1] 

机构地区：[1]中国医科大学绍兴医院普通外科,浙江绍兴312030

出　　处：《中国普通外科杂志》2014年第5期639-642,共4页China Journal of General Surgery

摘　　要：目的：探讨超声刀在开放性甲状腺手术中应用的有效性及安全性。方法：采用前瞻性随机对照方法，将2010年2月—2012年5月210例患者分为超声刀组与电刀组，各105例，分别采用超声刀与传统电刀手术方法行开放性甲状腺切除术，手术均由普外科甲状腺手术经验丰富同一手术团队完成。比较两组在不同手术方式中手术时间、术中出血量、术后引流量、术后并发症等指标。结果：两组患者年龄、性别、肿块大小及疾病构成比差异无统计学意义（均P〉0.05）。在相同的手术方式中，超声刀组手术时间手术、术中出血量及术后引流量（减少10-40 mL）均较传统结扎结合电刀组明显减少，组间差异均有统计学意义（P〈0.05）；两组间术后并发症的差异无统计学意义（P〉0.05）。结论：超声刀集切割、止血于一体，简化手术操作过程；在开放性甲状腺手术中应用超声刀，可缩短手术时间，减少出血。Objective： To investigate the efficacy and safety of the use of harmonic scalpel in open thyroid surgery.Methods： Using a prospective randomized controlled trial design, 210 patients from February 2010 to May 2012 were divided into harmonic scalpel group and electric scalpel group with 105 cases in each group, and underwent open thyroidectomy with harmonic scalpel and conventional electric scalpel, respectively. All operations were completed by the same surgical team with a wide experience in thyroid surgery. The operative time, intraoperative blood loss and postoperative drainage volume for the same type of surgery, and postoperative complications between the two groups were compared.Results： There was no significant difference in age, sex, tumor size or type of disease between the two groups （all P〉0.05）. The operative time, intraoperative blood loss and postoperative drainage volume for the same type of surgery in harmonic scalpel group were all reduced compared with electronic scalpel group, with all differences reached a statistical significance （all P〈0.05）. No statistical difference was noted in postoperative complications between the two groups （P〉0.05）.Conclusion： Harmonic scalpel combines hemostasis and sectioning in a single instrument, which simplifies the surgical procedure; use of harmonic scalpel in open thyroid surgery can shorten operative time and reduce intraoperative bleeding.

关 键 词：甲状腺切除术 超声刀 随机对照试验 

分 类 号：R653.2[医药卫生—外科学]