腔镜甲状腺手术中不同张力操作对甲状腺肿瘤患者甲状旁腺的影响  

The influence of different tension manipulations on parathyroid glands in patients with thyroid tumors during endoscopic thyroid surgery

作　　者：单二波[1] 周少波[1] 褚亮[1] 蒋磊[1] Shan Erbo(The second affiliated hospital of Bengbu Medical College,Bengbu,Anhui,233000,China)

机构地区：[1]蚌埠医学院第二附属医院,安徽蚌埠233000

出　　处：《齐齐哈尔医学院学报》2021年第15期1327-1330,共4页Journal of Qiqihar Medical University

基　　金：安徽高校协同创新项目(GXXT-2019-014);蚌埠医学院校级课题(BYKY2019139ZD)。

摘　　要：目的探讨腔镜甲状腺手术中不同张力操作对甲状腺肿瘤患者甲状旁腺的影响。方法选择2017年1月—2019年6月本院收治的拟行腔镜甲状腺手术的108例甲状腺肿瘤患者作为研究对象,随机数表法分为对照组和观察组两组,每组各54例。在术中解剖甲状旁腺过程中,对照组采取高张力解剖,观察组采取低张力解剖。比较两组手术情况、围术期各项信息、术中上位甲状旁腺血运、并发症发生及血清甲状旁腺激素(PTH)、血钙水平变化情况。结果两组患者均顺利完成手术,在切口长度、术后住院时间上差异均无统计学意义(P>0.05);观察组手术时间明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P<0.05);观察组术中上位甲状旁腺血运分度明显优于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为3.7%,明显低于对照组的14.8%,差异有统计学意义(P<0.05);观察组术后1 d、3 d血清PTH、血钙水平均明显高于对照组,差异均有统计学意义(P<0.05)。结论腔镜甲状腺手术中低张力解剖甲状腺肿瘤患者的甲状旁腺,对甲状旁腺血运影响小,有效保护其功能,减少并发症发生,值得进一步研究应用。Objective To investigate the influence of different tension operations on parathyroid glands in patients with thyroid tumors during endoscopic thyroid surgery.Methods 108 patients with thyroid tumor who underwent laparoscopic thyroid surgery in our hospital from January 2017 to January 2019 were enrolled in the study,they were randomly divided into the control group and the observation group,54 cases in each group.During the surgical dissection of the parathyroid glands,the control group was dissected with high tension,the observation group was dissected with low tension.The operation status,perioperative information,intraoperative upper parathyroid blood supply,complications,serum parathyroid hormone(PTH)and blood calcium levels were compared between the two groups.Results Both groups of patients successfully completed the operation,there was no significant difference in length of incision and postoperative hospital stay(P>0.05).The operation time of the observation group was significantly shorter than that of the control group,the intraoperative blood loss was significantly less than that of the control group,and the differences were statistically significant(P<0.05).The intraoperative upper parathyroid blood supply was significantly better than the control group,the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 3.7%,which was significantly lower than that in the control group(14.8%),the difference was statistically significant(P<0.05).The serum PTH and serum calcium level in the observation group at 1 day and 3 days after operation were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Parathyroid gland dissected under low-tension operation during endoscopic thyroid surgery has little effect on the blood supply of parathyroid glands,effectively protects its function and reduces complications,worthy of further research and application.

关 键 词：甲状腺肿瘤 腔镜甲状腺手术 低张力 高张力 甲状旁腺 

分 类 号：R736.1[医药卫生—肿瘤]