双极电凝镊在甲状腺手术中的应用效果  

Application effect of bipolar coagulation forceps in thyroid surgery

作　　者：殷放[1] 邓琳[1] 翁泽滨[1] YIN Fang;DENG Lin;WENG Ze-bin(Department of Thyroid and Breast Surgery,Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,China)

机构地区：[1]中山大学附属第五医院甲状腺乳腺外科,519000

出　　处：《中国实用医药》2022年第21期66-68,共3页China Practical Medicine

摘　　要：目的分析双极电凝镊在甲状腺手术中的应用效果。方法600余例行甲状腺手术的患者,排除既往有甲状腺手术史、术前已有声音改变、术中发现有喉返神经侵犯者,最终纳入530例患者,根据术中使用手术器械不同分为双极电凝镊游离组(220例)、超声刀游离组(200例)和电刀游离组(110例)。三组患者均进行甲状腺腺叶的全切除或近全切除手术,双极电凝镊游离组术中以双极电凝镊游离喉返神经及甲状旁腺,超声刀游离组术中以超声刀游离喉返神经及甲状旁腺,电刀游离组术中以单极电刀游离喉返神经和甲状旁腺。比较三组患者术后发生喉返神经麻痹和甲状旁腺损伤发生情况。结果双极电凝镊游离组患者术后发生喉返神经麻痹3例(1.36%),甲状旁腺损伤5例(2.27%);超声刀游离组患者术后发生喉返神经麻痹10例(5.00%),甲状旁腺损伤13例(6.50%);电刀游离组患者术后发生喉返神经麻痹13例(11.82%),甲状旁腺损伤15例(13.64%)。三组患者术后喉返神经麻痹及甲状旁腺损伤发生率比较差异均有统计学意义(P<0.05);双极电凝镊游离组患者术后喉返神经麻痹及甲状旁腺损伤发生率均显著低于超声刀游离组及电刀游离组,超声刀游离组患者术后喉返神经麻痹及甲状旁腺损伤发生率均低于电刀游离组,差异均有统计学意义(P<0.05)。结论应用双极电凝镊进行甲状腺手术精细化解剖可降低术中喉返神经麻痹和甲状旁腺损伤的发生率,较大程度提高手术安全性及患者生活质量,值得临床推广。Objective To analyze the application effect of bipolar coagulation forceps in thyroid surgery.Methods More than 600 patients who underwent thyroid surgery were included,and those with a history of previous thyroid surgery,preoperative voice changes,and invasion of the recurrent laryngeal nerve during surgery were excluded.530 patients were finally included and divided into the bipolar coagulation forceps free group(220 patients),ultrasonic knife free group(200 patients),and electric knife free group(110 patients)according to different practical intraoperative surgical instruments.All three groups underwent total or near-total thyroid lobectomy.In the bipolar coagulation forceps free group,bipolar coagulation forceps was use to free the recurrent laryngeal nerve and parathyroid glands;in the ultrasonic knife free group,ultrasonic knife was use to free the laryngeal nerve and parathyroid glands;in the electric knife free group,the electric knife was use to free the laryngeal nerve and parathyroid glands.The occurrence of postoperative recurrent laryngeal nerve palsy and parathyroid injury in the three groups were compared.Results In the bipolar coagulation forceps free group,the incidences of postoperative recurrent laryngeal nerve palsy and parathyroid injury were 3 cases(1.36%)and 5 cases(2.27%);in the ultrasonic knife free group,the incidences of postoperative recurrent laryngeal nerve palsy and parathyroid injury were 10 cases(5.00%)and 13 cases(6.50%);in the electric knife free group,the incidences of postoperative recurrent laryngeal nerve palsy and parathyroid injury were 13 cases(11.82%)and 15 cases(13.64%).There was no statistically significant difference in incidence of postoperative recurrent laryngeal nerve palsy and parathyroid injury among the three groups(P<0.05).The incidences of postoperative recurrent laryngeal nerve palsy and parathyroid injury in the bipolar coagulation forceps free group were significantly lower than those of the ultrasonic knife free group and electric knife free group,and the

关 键 词：双极电凝镊 甲状腺手术 喉返神经 甲状旁腺 

分 类 号：R653[医药卫生—外科学]