超声检查对腔镜甲状腺手术价值的探讨

Discussion of the value of ultrasonic examination in laparoscope's thyroidectomy

目的探讨超声检查对腔镜甲状腺的手术价值。方法对2003年5月至2005年7月之间所进行的41例腔镜甲状腺手术患者在术前应用二维超声以及彩色多普勒对甲状腺峡部的长度、厚度以及气管在胸骨上窝的深度,气管侧弯状态,甲状腺下极与锁骨、胸骨的关系,向后方生长肿大的腺体超过胸锁乳突肌的程度,肿物在腺体内的数量、位置和大小,肿物的性质(实性、囊性、混合性),血流的变化进行甲状腺检测。结果41例腔镜甲状腺手术中有1例中转开放手术。1例甲亢复发。1例术后发声嘶哑,1个月后恢复正常。无气管及甲状旁腺损伤,无术后大出血。手术平均时间125min(86～193min)。术中出血平均50ml(10～130ml)。平均住院时间9d(6～15d)。结论术前超声检查了解甲状腺以及周围情况直接关系到腔镜甲状腺手术的成败与效果。

Objective To discuss the value of ultrasonic examinion in laparoscope＇s thyroidectomy. Methods 41 cases who were performed in laparoscope＇ s thyroidectomy were checked by color Doppler flow imaging and two dimensional sonography, the key of examination： （ 1 ）The length and depth of thyroid isthmitis. （2）Trachea curve degree and the depth in up-sternum. （3）The reference between thyroid, calvicle and sternum. （4）Thyroid tumefaction degree over stemomastoid. （ 5 ） Thyroid turner＇ s number, position and size. （ 6 ） Turner＇ s kind. （ 7 ） Bloodstream change. Results Only 1 case turned open. 1 case recured in hyperthyroidism. Hoarseness occured in loose after operation and come-into being after 1 mouth. No trachea and parathyroid hurt appeared in any cases. The mean operation time was 125 minutes（range 86 to 193 minutes）.The mean time stay in hospital was 9 days（range 6 to 15 days）. Conclusion Ultrasonic examination before operation is very valuable.