持续负压吸引排气法在经胸途径腔镜甲状腺手术的应用研究  

Clinical application of continuous vacuum evacuation in endoscopic thyroidectomy by transthoracic approach

作　　者：黄进团 黄荣辉[1] 曾玉友[1] 

机构地区：[1]惠州市第三人民医院普外科,广东省516002

出　　处：《中华普外科手术学杂志（电子版）》2015年第3期53-55,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：惠州市科技计划项目(20140802)~~

摘　　要：目的探讨持续负压吸引排气法在经胸途径腔镜甲状腺手术的应用价值。方法将62例患者随机分为两组,每组31例,常规组术中以常规法排除烟雾干扰;排气法组使用自制改良设备进行腔镜手术,全程持续负压吸引排气,记录术中自切皮始至制造操作空间止所用时间,操作空间制作结束到甲状腺肿块完全切除所用时间,采用SPSS19.0统计软件分析,两个手术阶段耗时及术中镜头清洗次数、术中出血量比较采用(x珋±s)表示,t检验;两组术后并发症比较采用χ2检验。P<0.05差异有统计学意义。结果排气法组在制造操作空间方面耗时明显短于常规组,而镜头清洗次数也较少,差异有统计学意义(t=4.30、5.56,P<0.05);在切除甲状腺的耗时及术中出血量方面,两者差异无统计学意义(P>0.05);术后常规组有13例(41.9%)出现并发症,排气法组有1例(3.2%)因喉返神经损伤所致术后声嘶患者,两组并发症发生率差异有统计学意义(χ2=13.29,P<0.05)。结论自制改良器械在经胸途径腔镜甲状腺手术中持续负压吸引排气,能够有效消除烟雾,对手术产生积极影响,值得推广。Objective To investigate the clinical outcome of continuous vacuum evacuation in endoscopic thyroidectomy （ET） by the transthoracic approach. Methods 62 patients with ET indications were selected and randomly divided into two groups, each group of 31 cases, convention group （ CG ） evacuating smog by conventional method and exit gas group （EGG） used a modified operative instrument for continuously evacuating smog. The results were compared on the consuming time in establishing the operation space and thyroid ablation, the frequency of Lens cleaning, intraoperative blood loss and complications; Statistical analysis were performed by using SPSS19.0 software, and the consuming time, thyroid ablation, frequency of Lens cleaning, amount of bleeding were expressed as （x ＋ s ） and were compared by t test, while comparison of complications by X2 test. P value 〈 0.05 was considered as significant difference. Results Compared with convention group, the consuming time of establishing the operation space, the frequency of Lens cleaning were less in EGG （ t = 4.30, 5.56 respectively, P 〈 0.05 ）. There was no significant difference between 2 groups in consuming time in thyroid ablation and amount of bleeding （ P 〉 0.05）. The rate of complication after operation was 41.9% in CG and 3.2% in EGG, with significant difference （x2 = 13.29, P 〈 0.05 ）. Conclusion The modified operation instrument in ET could help to evacuate the smog effectively and worth popularization

关 键 词：甲状腺疾病 持续负压吸引 胸腔镜检查 甲状腺切除术 烟雾吸入损伤 

分 类 号：R653[医药卫生—外科学]