改良式腹腔镜下甲状腺瘤切除术300例临床分析  

Clinical Analysis of 300 Cases with Modified Laparoscopic Thyroidectomy

作　　者：罗远柬 LUO Yuan-jian(Department of General Surgery,Tengxian People＇ s Hospital,Tengxian,Guangxi,543300 China)

机构地区：[1]广西藤县人民医院普通外科,广西藤县543300

出　　处：《系统医学》2018年第5期141-144,共4页Systems Medicine

摘　　要：目的探讨县级医院改良式腹腔镜下甲状腺瘤切除术300例临床分析。方法 2012年1月—2017年5月,医院常规腹腔镜甲状腺切除300例,单发202例,双发98例。全甲状腺切除术或近甲状腺切除术291例,甲状腺腺叶加峡部切除9例。全麻手术,全部胸乳路径300例。对两组的手术时间、术中出血量术后引流量、引流管拔除时间以及术后并发症和患者满意度等情况进行对比。结果手术时间(70±50)min,术中出血量(35.6±9.5)m L。术后引流管引流量(101.7±25.)m L,引流管拔除时间(75.6±11.9)h。术后住院时间(80.5±14.2)h,切口长度(3.4±0.2)cm。术后有并发症12例(4%),患者未见对切口不满意的对象,非常满意84.3%。术后均随访(6.8±2.2)个月。末次随访,T3、T4、TSH低于术前,FT4、FT3高于术前,差异有统计学意义(P<0.05)。有并发症对象年龄>60岁、吸烟、超重会肥胖、慢性呼吸系统疾病、甲状腺结节、术前气管压迫症状、高频电刀、术中损伤甲状旁腺、术中损伤喉返神经、2016年前比重与对照组差异有统计学意义(P<0.05)。结论县级医院开展腹腔镜甲状腺切除术整体上质量已较好,技术已经不断成熟,已经逐渐普及。在术中巧秒地使用电钩配合超声刀操作,方法简单便捷有效,术后术后并发症少,值得在基层推广。Objective To study the clinical analysis of 300 cases with modified laparoscopic thyroidectomy in the county-level hospitals. Methods 300 cases of patients with routine laparoscopic thyroidectomy in our hospital from January2012 to May 2017 were selected, including 202 cases with single tumor, and 98 cases with double tumor, and 291 cases were treated with total thyroidectomy, 9 cases treated with thyroid lobe with isthmus resection, and 300 cases were for general anesthesia surgery and total chest breast path, and the operation time, intraoperative bleeding amount, postoperative drainage, removal time of drainage tube, postoperative complications and satisfactory degree of patients were compared between the two groups. Results The operation time, intraoperative bleeding amount, drainage volume of postoperative drainage tube, removal time of drainage tube, and postoperative length of stay, and incision length were respectively（70±50） min,（35.6±9.5）m L,（101.7±25.）m L,（75.6±11.9） h, all patients were followed up for 6 months after operation（80.5±14.2）h,（3.4±0.2） cm and 12 cases（4%）, and no one was unsatisfied with the incision, 84.3% were very satisfied, and the last follow-up was（6.8±2.2） months, which showed that the T3,T4,TSH were lower than those before surgery, and the FT4,FT3 were higher than those before surgery, and the differences were statistically significant（P〈0.05）, and the differences in the ratios of the age of complication objects 60 years old, smoking, overweight and obesity, chronic respiration system disease, thyroid nodules, preoperative tracheal compression symptoms, endotherm knife,intraoperative injured parathyroid glands, intraoperative injured recurrent laryngeal nerve, between the two groups before 2016 were statistically significant（P〈0.05）. Conclusion The holistic quality of laparoscopic thyroidectomy in the county-level hospitals is better, and the technology has constantly become mature, and the application of electric hook and ultraso

关 键 词：县级医院 腹腔镜 甲状腺手术 

分 类 号：R615[医药卫生—外科学]