双极电凝系统与超声刀在甲状腺手术中应用效果观察  

Effects of bipolar coagulation forceps and harmonic scalpel in open thyroid surgery

作　　者：邱堃[1] 王一森[1] 吴元清[1] 

机构地区：[1]海南省第二人民医院普外科,572200

出　　处：《中华普外科手术学杂志（电子版）》2015年第6期47-49,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的研究双极电凝系统与超声刀在甲状腺手术中的应用效果。方法将2013年2月至2015年2月94例接受甲状腺手术治疗患者随机分为超声刀组和电刀组,超声刀组51例,电刀组43例。超声刀组患者采用超声刀结合双击电凝进行手术,电刀组采用超声刀结合传统结扎方法进行手术。对比两组患者术中指标、术后恢复速率、并发症及复查结果。应用SPSS 18.0软件包进行数据处理,术中和术后等计量资料以（±s）表示,采用t检验;术后并发症等计数资料采用χ~2检验。P〈0.05为差异具有统计学意义。结果超声刀组患者出血量为（11.4±2.7）ml、切口大小为（4.2±0.5）cm、手术时间为（34.5±6.4）min均显著低于电刀组的（16.6±4.8）ml、（5.1±0.7）cm、（42.1±8.6）min（t=6.312、7.050、4.785,P〈0.01）。超声刀组患者术后引流量显著高于电刀组（t=4.588,P〈0.01）;超声刀组暂时性甲状旁腺功能低下发生率低于电刀组（χ~2=4.372,P〈0.05）。结论双极电凝系统与超声刀配合使用在甲状腺手术中具有良好的应用效果,可以减少手术时间和术中损伤降低并发症发生率。Objective To investigate the clinical effects of bipolar coagulation forceps and harmonic scalpel in open thyroid surgery. Methods A total of 94 patients undergoing open thyroid surgery were randomly divided into a harmonic scalpel group（ 51 patients） and an electrotome group（ 43 patients）.Patients in the electrotome group were treated by the harmonic scalpel technique pen thyroid surgery,and patients in the harmonic scalpel group were treated by bipolar coagulation forceps and harmonic scalpel technique open thyroid surgery. The operative indexes,post-operative recovery indexes,complications and review outcomes were compared between the two groups. SPSS 18. 0 software was employed to analyze the data. Measurement data were represented as mean ± SD and examined by Student＇s t test. Accumulated data were examined by the chi-square test. Results Blood loose was（ 11. 4 ± 2. 7） ml,incision size was（ 4. 2 ± 0. 5） cm and surgery time was（ 34. 5 ± 6. 4） min in the harmonic scalpel group,all of which were significantly less than（ 16. 6 ± 4. 8） ml,（ 5. 1 ± 0. 7） cm,（ 42. 1 ± 8. 6） min in the electrotome group（ P〈0. 01）. The post drainage volume in the harmonic scalpel group was significantly higher than that in the electrotome group（ t = 6. 312,7. 050,and 4. 785,P〈0. 01）. The drainage volume of the harmonic scalpel group was significantly higher than that in the electrotome group（ t = 4. 588,P〈0. 01）. The incidence of temporary hypoparathyroidism in the harmonic scalpel group was significantly less than that in the electrotome group（ χ~2= 4. 372,P〈0. 05）. Conclusion Bipolar coagulation forceps combined with harmonic scalpel for open thyroid surgery can reduce operative time,injury,and the incidence of complications.

关 键 词：甲状腺肿瘤 甲状腺切除术 淋巴结切除术 电凝术 超声手术刀 

分 类 号：R653[医药卫生—外科学]