甲状腺再次手术不同切口的比较研究  

To explore the operative approaches of reoperation on thyroid gland

作　　者：杨乐[1] 刘兆龙[1] 孙燕翔[1] 

机构地区：[1]上海中医药大学附属曙光医院普外科,上海201203

出　　处：《中国医刊》2016年第11期39-41,共3页Chinese Journal of Medicine

摘　　要：目的探讨甲状腺再次手术选择不同手术切口的临床疗效。方法选取2008年1月至2016年1月本院收治的甲状腺再手术患者230例为研究对象,根据手术入路的不同分为观察组与对照组,每组患者115例,其中对照组患者行原切口入路,观察组患者行原切口入路与侧入路相结合,术后比较两组患者的出血、声音嘶哑、甲状旁腺功能减退、伤口感染及肿胀情况并分析。结果经过数据分析,结果显示对照组患者的术中出血量、术后出血量以及术后再次手术止血率均明显高于观察组,组间比较差异具有显著性(P<0.05);对照组患者的术后暂时性甲状旁腺功能减退比例明显高于观察组,组间比较差异具有显著性(P<0.05);对照组患者的术后伤口肿胀发生率及消退时间均明显高于观察组,组间比较差异具有显著性(P<0.05);两组患者术后感染发生率比较差异无显著性(P>0.05);对照组患者的术后暂时性声音嘶哑、迟发性声音嘶哑发生率均明显高于观察组,组间比较差异具有显著性(P<0.05)。两组患者均未发生永久性声音嘶哑及甲状旁腺功能减退。结论甲状腺再次手术难度较大,术后并发症较多,选择原切口入路与侧入路相结合的方式,可降低术后并发症的发生率,提高手术效率及安全性,值得临床推广应用。Objective To investigate the clinical efficacy of different surgical options thyroid incision again.Method January 2008 to January 2016 I was admitted to hospital thyroid surgery 230 patients for the study,depending on the surgical approach is divided into the observation group and the control group,115 cases of patients in each group,in which the control group patients with primary incision in the observation group patients after the original incision and lateral approach combined the postoperative bleeding,hoarseness,hypoparathyroidism,wound infection and swelling and analyzed.Result Through data analysis,the results show that the control group of patients with bleeding volume,postoperative bleeding volume and postoperative bleeding rates were significantly higher than the observation group,the difference between the groups was significant（P〈0.05）;the control group of patients with preoperative after temporary hypoparathyroidism was significantly higher than the observation group,a significant difference between the two groups（P〈0.05）;the incidence of postoperative wound swelling in the control group patients and subsided time were significantly higher than in the observation group,the difference between groups significantly（P〈0.05）;the postoperative infection rate was no significant difference（P〉0.05）;the control group of patients with postoperative transient hoarseness,hoarseness delayed incidence was significantly higher than the observation group,significant difference between the two groups（P〈0.05）.Two groups of patients were not there permanently hoarse voice.Two groups of patients were not a permanent hoarseness and hypoparathyroidism.Conclusion Thyroid reoperation difficult,more complications,choose the original incision and into the side of the road combination,can reduce the incidence of postoperative complications and improve the efficiency and safety of operation,worthy of clinical application.

关 键 词：甲状腺再手术 原切口入路 侧入路 

分 类 号：R335.2[医药卫生—人体生理学]