结节性甲状腺肿手术操作技巧的探讨

Research on surgical skill for the operation of nontoxic nodular goiter

目的探讨结节性甲状腺肿手术中应用囊内操作和综合无血术野操作技巧对手术效果的影响。方法采用回顾性分析的方法,收集1998-2003年因结节性甲状腺肿住院,并在手术中应用上述操作技巧的病例,分析并发症的发生率。结果 5年中共行结节性甲状腺肿手术1 256例,其中喉返神经损伤2例,占 0．16％;术后切口内出血3例,占0．24％;甲状旁腺损伤2例,占0．16％。结论在遵循规范化的结节性甲状腺肿手术中,应用新的操作技巧,可减少和避免并发症的发生。

Objective To discuss the operating skills, such as operating inside the membranes propria of thyroid and minimizing the hemorrhage in the surgical area, during the process of thyroidectomy for nodular goiter. Methods Patients with nodular goiter undergoing thyroidectomy during 1998 to 2003, which involved such skills, were retrospectively analyzed, and the complication rate was ananlyzed. Results Among the 1 256 operations of nodular goiter in the 5 years, complications occurred very infrequently, including 2 cases of the injury of recurrent laryngeal nerve （0.16%）, 3 cases of postoperative hemorrhage inside incision （0.24%）, 2 cases of injury of parathyroid （0.16%）. Conclusions When following the steps of the standard of throidectomy for nodular goiters, such new operating skills could reduce and even avoid the complications from thyroidectomy.