经胸骨端入路离断颈前肌群翻转固定在双侧巨大甲状腺肿物手术中的优势分析  

The advantage analysis of anterior cervical muscle group approach at sternal end transection in removal of bilateral huge thyroid neoplasm

作　　者：常海宏 曹农[2] 

机构地区：[1]甘肃省康乐县人民医院普外科,731500 [2]兰州大学第一附属医院普外科

出　　处：《中国医师进修杂志》2014年第20期41-43,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨经胸骨端入路离断颈前肌群翻转固定在双侧巨大甲状腺肿物手术中的应用优势。方法选择行双侧巨大甲状腺肿物手术患者107例，采用机械抽样法随机分为两组，其中采用经颈白线切口行甲状腺手术52例（对照组），采用经胸骨端人路离断颈前肌群翻转固定法完成甲状腺手术55例（观察组），分别对两组患者的手术时间、手术野显露效果、术中出血量、术后并发症及术后引流量进行比较。结果观察组的手术时间[（88．53±5．95）min]、术中出血量[（18．58,±5．95）ml]及术后引流量[（47．58±14．76）ml]均少于对照组[分别为（113．98±15．85）min、（39．27±16．32）ml、（73．90±14．40）ml]，差异有统计学意义（P〈0．05），术后并发症发生率低于对照组[7．3％（4／55）比13．5％（7／52）]，差异有统计学意义（P〈0．05）；手术野显露效果也优于对照组，差异有统计学意义（P〈0．05）。结论经胸骨端入路离断颈前肌群翻转固定行双侧巨大甲状腺肿物手术是可行的，手术操作简便，手术野显露优于颈白线入路，且术后并发症少，值得临床推广。Objective To explore the advantage of anterior cervical muscle group approach at sternal end transection in removal of bilateral huge thyroid neoplasm. Methods One hundred and seven patient underwent removal of bilateral huge thyroid neoplasm were selected. Fifty-two patients were given neck white line incision thyroid surgery （control group） and 55 patients were given anterior cervical muscle group approach at sternal end transection for thyroid surgery （observation group）. The operative time, operation field exposure effect, amount of bleeding in operation, postoperative complications, and postoperative drainage volume were compared between two groups. Results The operative time [ （88.53 ± 5.95） min ], amount of bleeding [ （ 18.58 ± 5.95 ） ml ], and postoperative drainage volume [ （47.58 ± 14.76） ml ] in observation group were less than those in control group [（113.98 ± 15.85） rain, （39.27 ± 16.32） ml, （73.90 ± 14.40） ml] （P 〈 0.05）,the postoperative complication rate was lower than that in control group （P 〈 0.05）. Operation field exposure effect in observation group was better than that in control group （P 〈 0.05）. Conclusions Removal of bilateral huge thyroid neoplasm with the sternal end approach is feasible and simple. The operation field exposure is better than the neck white line incision, complications after operation is less. It is worthy of clinical application.

关 键 词：甲状腺切除术 治疗结果 经胸骨端入路 离断颈前肌群 

分 类 号：R653[医药卫生—外科学]