经胸锁乳突肌肌间入路行单侧甲状腺手术的临床效果观察  

Observation on the clinical effect of unilateral thyroidectomy through the sternocleidomastoid intermuscular approach

作　　者：庄颖颖[1] 林炘[1] 肖映胜 ZHUANG Ying-ying;LIN Xin;XIAO Ying-sheng(Department of Thyroid Surgery,Shantou Central Hospital,Shantou 515000,China)

机构地区：[1]广东省汕头市中心医院甲状腺外科,515000

出　　处：《中国实用医药》2022年第13期5-8,共4页China Practical Medicine

摘　　要：目的 探索经胸锁乳突肌肌间入路的甲状腺手术对颈前区功能的保护效果。方法 84例单侧甲状腺良性结节患者,按手术方式不同分为观察组与对照组,各42例。观察组接受经胸锁乳突肌肌间入路甲状腺手术治疗,对照组接受传统经颈白线入路切除手术治疗。比较两组围术期相关指标、并发症发生情况、术后颈部主观感觉评分。结果 观察组切口长度(3.55±0.32)cm短于对照组的(4.56±0.41)cm,引流量(23.5±3.5)ml少于对照组的(33.4±4.5)ml,差异均有统计学意义(P<0.05)。两组的手术时间、出血量、住院时间比较,差异无统计学意义(P>0.05)。观察组并发症发生率4.8%低于对照组的19.1%,差异有统计学意义(P<0.05)。术后1 d、1周、1个月,观察组颈部主观感觉评分均低于对照组,差异有统计学意义(P<0.05)。结论 采用经胸锁乳突肌肌间入路行甲状腺手术治疗甲状腺良性结节时,可在不增加手术时间及喉返神经损伤率等风险前提下,更好的保护颈前区功能并增加术后术区的美观性。Objective To investigate the protective effect of unilateral thyroidectomy through the sternocleidomastoid intermuscular approach on the function of the anterior cervical region.Methods A total of 84 patients with unilateral benign thyroid nodules were divided into observation group and control group according to different surgical methods,with 42 cases in each group.The observation group received thyroidectomy through the sternocleidomastoid intermuscular approach,and the control group received the traditional section through transcervical white line approach.The perioperative related indicators,occurrence of complications,and the postoperative neck subjective sensation score were compared between the two groups.Results The incision length(3.55±0.32)cm of the observation group was shorter than(4.56±0.41)cm of the control group,and the drainage volume(23.5±3.5)ml was less than(33.4±4.5)ml of the control group.All the differences were statistically significant(P<0.05).There was no statistically significant difference in operation time,blood loss and hospitalization time between the two groups(P>0.05).The complication rate 4.8%in the observation group was lower than 19.1%in the control group,and the difference was statistically significant(P<0.05).At 1 d,1 week,and 1 month after surgery,the neck subjective sensation score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Thyroid surgery through the sternocleidomastoid intermuscular approach for benign thyroid nodules can better protect the function of the anterior cervical region and increase the aesthetics of the postoperative area without increasing the risk of surgery time and the rate of injury to the recurrent laryngeal nerve.

关 键 词：甲状腺手术 经胸锁乳突肌肌间入路 颈前区功能 

分 类 号：R653[医药卫生—外科学]