不离断颈前肌群甲状腺叶切除术

Untransection of anterior cervical muscles in the thyroidectom.

目的探讨不离断颈前肌群行甲状腺叶切除术的可能性。方法把163例甲状腺疾病患者根据甲状腺大小不同等情况，分别采取两种不同手术入路，在不离断颈前肌群的情况下行甲状腺叶切除术。结果163例患者术中均暴露良好，无死亡病例及术中术后窒息现象。主要并发症有暂时性喉返神经损伤1例，永久性喉返神经损伤1例。结论除了胸骨后甲状腺需胸骨劈开手术及甲状腺癌需行颈淋巴结清扫的情况外。根据甲状腺不同情况分别选择经颈白线入路或颈深筋膜入路不离断颈前肌群行甲状腺叶切除术安全可行。且术野均暴露良好，手术创伤较小，术后痛性硬结、皮肤粘连等并发症少，切口美观。

Objective To study the effect untransection of anterior cervical muscles on the thyroidectom operation. Methods 163 patients suffered from underwent thyroidectom with different surgical operation method according to the size of hypothyroids, the thyroids of anterior cervical muscles were untransectioned in the thyroidectom. Results 163 patients were better , no dead and apnea eases. There is one case have complication of temporary harm of recurrent laryngeal nerve, and one have permanent harm of recurrent laryngeal nerve,Concluslons Besides retrostemal thyroid should be carried out by intrathoracic surgery, and thyroid cancer by redical neck dissection, incise finea alba cervicalis or through cervical deep fascia, untransection of anterior cervical muscles in the thyroidectom is feasible, manifest thyroid better, a little damage, the complication of painful hard knot and skinconglutination is less ,and the notch is slinky,