颈部切口联合锁骨部分切除入路治疗胸骨后甲状腺肿的临床效果观察  

Clinical Effect of Cervical Incision Combined with Partial Clavicular Resection Approach in Treatment of Substernal Goiter

作　　者：周振玉[1] ZHOU Zhenyu(Department of General Surgery,General Hospital of Mining Industry Group in Fuxin,Fuxin 123000,Liaoning Province,China)

机构地区：[1]阜新矿业集团总医院普通外科,辽宁阜新123000

出　　处：《中国实用乡村医生杂志》2018年第11期66-68,共3页Chinese Practical Journal of Rural Doctor

摘　　要：目的 探讨颈部切口联合锁骨部分切除入路治疗胸骨后甲状腺肿的效果.方法 回顾性分析2006年1月—2017年1月阜新矿业集团总医院收治的44例胸骨后甲状腺肿患者的临床资料,其中2006年1月—2013年12月收治的33例患者采用联合胸骨劈开入路(胸骨劈开组),2014年1月—2017年1月收治的11例患者采用联合锁骨部分切除入路(锁骨部分切除组).观察并比较两组的手术时间、术中出血量和术后并发症发生率.结果 手术时间:胸骨劈开组(230±35)min,锁骨部分切除组(160±25)min,差异有统计学意义(t=3.60,P＜0.05).术中出血量:胸骨劈开组(590±60)mL,锁骨部分切除组(315±40)mL,差异有统计学意义(t=4.43,P＜0.05).术后胸骨劈开组喉返神经损伤及胸导管损伤发生率均为3.0%,肺部感染发生率为36.4%,锁骨部分切除组均未出现上述并发症,两组并发症发生率差异有统计学意义(χ2=5.03,P＜0.05).结论 颈部切口联合锁骨部分切除入路治疗胸骨后甲状腺肿,操作简单,手术时间、术中出血量及术后并发症发生率均优于胸骨劈开入路,值得临床推广应用.Objective To investigate the effect of cervical incision combined with partial clavicular resection approach in treatment of substernal goiter. Methods The clinical data of 44 patients with substernal goiter from January 2006 to January 2017 were retrospectively analyzed, including 33 patients with substernal goiter received sternotomy approach (sternotomy group) from January 2006 to December 2013, and 11 patients with substernal goiter received partial clavicular resection approach (partial clavicular resection group) from January 2014 to January 2017. Operation time, intraoperative blood loss, and the incidence rate of complications were compared between two groups. Results The operation time was (230±35 )minutes in the sternotomy group and (160±25) minutes in the partial clavicular resection group, existing significant difference between the two groups(t=3.60, P<0.05). The intraoperative blood loss was (590±60)mL in the sternotomy group, and significantly more than (315±40)mL in the partial clavicular resection group (t=4.43, P<0.05). The incidence rate of recurrent laryngeal nerve injury and thoracic duct injury in the sternotomy group was 3.0%, and the rate of pulmonary infection was 36.4%. Compared with the sternotomy group, there was no complication occurred in the partial clavicular resection group (χ2=5.03, P<0.05). Conclusion The cervical incision combined with partial clavicular resection for substernal goiter has the characteristics of simple operation, short operation time, less intraoperative blood loss and no complication, which is worth popularizing.

关 键 词：甲状腺肿 甲状腺肿瘤 胸骨后外科手术 颈部切口 锁骨部分切除 

分 类 号：R736[医药卫生—肿瘤]