球囊扩张法在腔镜甲状腺手术中的应用  

Application of balloon dilatation in endoscopic thyroidectomy

作　　者：黄骏[1] 王子明[1] 汪志仿[1] 

机构地区：[1]武汉市中医医院,湖北武汉430014

出　　处：《腹腔镜外科杂志》2016年第4期281-283,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨球囊扩张法建立人工间隙及气体微循环排出非透明气体在经胸乳入路腔镜甲状腺手术中的应用价值。方法：回顾分析2015年4月至2015年6月23例胸乳入路腔镜甲状腺手术的临床资料,术中应用球囊扩张法建立人工间隙及气体微循环排出非透明气体。结果：23例手术均获成功,无一例中转开放。建立人工间隙时间15~29 min,平均（18.0±3.5）min;手术时间65~127 min,平均（84±19）min;术中出血量15~79 ml,平均（37.0±4.5）ml;引流管留置时间24~48 h,引流液为血清样,引流量31~95 ml,平均（57.0±11.3）ml;术后住院4~8 d,平均（6.0±1.2）d。2例发生声音嘶哑,分别于半个月及1个月后恢复。3例有胸前皮肤紧缩感。2例发生胸前皮下积液,对症治疗后恢复。结论：球囊扩张法在经胸乳入路腔镜甲状腺手术人工间隙制作中创伤小,方法简单,容易复制。气体微循环能迅速排出非透明气体,节省了大量非手术时间。Objective：To explore the application value of balloon dilatation for establishment of artificial space and gas microcirculation for nontransparent gas discharge in endoscopic thyroidectomy（ ET） by chest-breast approach.Methods：Clinical data of 23 patients who underwent endoscopic thyroid surgery from Apr.2015 to Jun.2015 were retrospectively analyzed.In operation,balloon dilatation was used for establishment of artificial space,and nontransparent gas was discharged by gas microcirculation.Results：All the 23 operations were successful without conversion to open operation in any cases.The average time of establishing artificial space was（ 18 ±3.5） min（ range,15-29 min）,while the average time of operation was（ 84 ± 19） min（ range,65-127 min）,the average operative bleeding volume was（ 37.0 ± 4.5） ml（ range,15-79 ml）.The time of drainage tube indwelling was 24-48 h,and the drainage fluid seemed to be the serum.The average volume of drainage was（ 57.0 ± 11.3） ml（ range,31-95 ml）,and the mean postoperative hospital stay was（ 6.0 ± 1.2） d（ range,4-8 d）.A hoarse voice occurred in 2 patients,who recovered in half and one month respectively.3 cases felt tight chest skin.The chest subcutaneous effusion appeared in 2 patients,who recovered after symptomatic treatment.Conclusions：Balloon dilatation method in ET by chest-breast approach is mini-invasive,establishment of artificial clearance is simple and easy to copy.Gas microcirculation can rapidly discharge the nontransparent gas,which can save a lot of non-operation time.

关 键 词：甲状腺切除术 内窥镜检查 胸乳入路 球囊扩张 

分 类 号：R653[医药卫生—外科学]