电凝钩在乳晕径路腔镜甲状腺手术中的临床应用

Clinical application of electric coagulation in the endoscopic thyroidectomy by breast approach for thyroid disease

目的:探讨电凝钩在乳晕径路腔镜甲状腺手术中应用的可行性和优点。方法:2002年8月到2005年5月采用胸部乳晕入路行腔镜甲状腺手术113例。31例(A组)使用超声刀分离皮下间隙,其中甲状腺腺瘤11例,结节性甲状腺肿20例。82例(B组)使用电凝钩分离皮下间隙,其中甲状腺腺瘤30例,结节性甲状腺肿52例。结果:A组的手术时间为(163.67±67.63)min,长于B组的(114.39±41.76)min,差异有统计学意义(P<0.05),A组术后第1天的引流量为(67.33±52.33)ml,平均67ml,B组的引流量为(95.48±86.42)ml,平均95ml。A组和B组术前、术后第1天和术后第3天的C-反应蛋白(CRP),术后第1天体温比较差异无统计学意义(P>0.05)。结论:电凝钩用于建立乳晕径路腔镜甲状腺手术的腔隙是安全可行的。

Objective：To explore the feasibility and advantage of endoscopic thyroidectomy by breast approach with electric coagulation.Methods：From Aug.2002 to May.2005,113 patients underwent endoscopic thyroidectomy.The subcutaneous operative space was created with ultrasonic scalpel（31 cases,include 11 adenoma,20 nodular goiter,group A）and electric coagulation（82 cases,include 30 adenoma,52 nodular goiter,group B）.Results：The operating time was significantly longer in group A （163.67±67.63）min than that in group B （114.39±41.76）min（P〈0.05）.The volum of drainage in group A were （67.33±52.33）ml（mean 67ml）,group B were （95.48±86.42）ml（mean 95ml）.There were no difference about C reaction protein（CRP） at preoperation and 1,3 days after operation（P〉0.05）.The temperature has no significant difference at 1 day after operation in group A and group B（P〉0.05）.Conclusions：The electric coagulation is safe to creat the subcutaneous operative space in the endoscopic thyroidectomy by breast approach.