腔镜膨胀液在颈部切口甲状腺手术中的应用研究  

Application of Endoscopic Inflation Fluidin Traditional Thyroidectomy

作　　者：张立永[1] 赵文新[1] 王波[1] 颜守义[1] 文佳[1] ZHANG Liyong;ZHAO Wenxin;WANG Bo(Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院,福建福州350001

出　　处：《中国医学创新》2018年第7期1-4,共4页Medical Innovation of China

基　　金：国家卫生部临床重点专科建设项目(卫办医政函[2012]649号);福建省卫生计生委青年科研课题(2017-2-22);福建医科大学教授学术发展基金(JS15017)

摘　　要：目的:探讨腔镜膨胀液在颈部切口甲状腺手术中应用的可行性。方法:选取2016年9-11月本院甲状腺外科拟行甲状腺手术患者,按照随机数字表法分为传统组(A组)与改良组(B组),B组应用腔镜膨胀液。比较两组分离皮瓣时间、术区时间、手术总时间、分离皮瓣出血量、术区出血量、术中总出血量、皮瓣分离前后血压、心率及血氧饱和度变化,术区引流量、皮下引流量、术后引流总量、术后痛觉评分、术后住院天数,统计术后出血、切口及术区感染例数。结果:两组均无术后出血、切口及术区感染等并发症。B组分离皮瓣时间、手术总时间、分离皮瓣出血量、术中总出血量、皮下引流量明显优于A组,B组术后痛觉评分明显小于A组,比较差异均有统计学意义(P<0.05)。术中总出血量与皮瓣出血量、术区出血量之间存在正相关性,手术总时间与分离皮瓣时间、术区时间之间存在正相关性,而术后引流总量只与术区引流量相关。结论:腔镜膨胀液在颈部切口甲状腺手术中应用可有效减少建立皮瓣分离时间、术区时间、术区出血量,并可减轻术后疼痛,增加术后舒适度,安全有效。Objective:To explore the feasibility of the application of endoscopic inflation fluid in traditional thyroidectomy.Method:Patients undergoing thyroidectomy from September to November 2016 in our hospital were randomly divided into traditional group and modified group which was treated by endoscopic inflation fluid.The separated flaps time,intraoperative time,totaloperation time,separated flapsblood loss,intraoperative blood loss,totaloperationblood loss,the changes of blood pressure during separated flaps,heart rate and Oxygen saturation(SpO2),intraoperativedrainage,subcutaneous drainage,post-operation drainage,post-operative pain score,post-operative hospital stay,and the number of post-operative blood loss and incision infection were respectively recorded and analyzed.Result:There were no complications of postoperative hemorrhage and incision infection in two groups.The separated flaps time,total operative time,separated flaps blood loss,total operative blood loss,subcutaneous drainage,post-operative pain score of modified group were less than those of traditional group,the differences were statistically significant(P<0.05).The separated flaps time,intraoperative time,total operation time were positively correlated with each other.These parated flaps blood loss,intraoperative blood loss,total operation blood loss were positively correlated with each other.The subcutaneous drainage and postoperation drainagewerepositively correlated with each other.Conclusion:Endoscopic inflation fluid was applied to traditional thyroidectomy,which might apparently reduce the separated flaps time,total operative time,intraoperative blood loss and alleviate post-operative pain.Therefore,the application of endoscopic inflation fluid is a safe and effective method for traditional thyroidectomy.

关 键 词：腔镜膨胀液 甲状腺手术 颈部切口 

分 类 号：R653[医药卫生—外科学]