甲状腺切除术中带肌侧径路与正中径路应用的比较研究

A Study of Comparison Between the Lateral Approach of Strap Muscles and the Middle Approach of Strap Muscles in Thyroidectomy

应用带状肌侧径路及带状肌正中径路完成３６例甲状腺侧叶与腺叶加峡部切除术，两径路组各１８例。带状肌侧径路组肿瘤大于正中径路组（４４ｃｍ±１９２ｃｍ，４．２ｃｍ±１６７ｃｍ，Ｐ＜００５），而切口长度（５５６ｃｍ±１４８ｃｍ，９４７ｃｍ±１７４ｃｍ，Ｐ＜０００１），甲状腺上极显露程度（Ｐ＜０００１），不横断带状肌例数（Ｐ＜０００５），手术时间（８０５６ｍｉｎ±３４２５ｍｉｎ，１４０５６ｍｉｎ±５７７５ｍｉｎ，Ｐ＜０００１），术中出血量（７０５７ｍｌ±６２０７ｍｌ，１６４４４ｍｌ±９８．５３ｍｌ，Ｐ＜０．０１）及术后负压引流量（２２．７８ｍｌ±１８．６５ｍｌ，４１６７ｍｌ±２４５５ｍｌ，Ｐ＜００２）等指标均以带状肌侧径路组为优。文中详细介绍了带状肌侧径路的手术操作，手术要点及其适应症。

36 cases with thyroid nodules were performed with hemithyroidectomy or a total thyroid lbectomy and isthmusectomy,with one group of 18 cases through tha lateral approach of strap muscles(LA),and another group os 18 cases through the conventional middle approach (MA).Although the tumor size in LA group is Larger than that of MA group (4.4±1.92cm,4.2±1 67cm,P<0.05),the incision length (5.56±1.48cm,9.47±1.74cm,P<0.0001),the exposed degree of thyroid superior pote(P<0.01),the operation time (80.56±34.25,140.56±57.75',P<0.001),the blood loos(70.57±62.07ml,164.44±98.53ml,P<0.01)and sunction drain (22.78±18.65ml,41.67±24.55ml,P<0.02)show that the LA is a better surgical approach in the thyroidectomy styles.The operatiae technique,operative key points and indicatiou of the LA are described in detail.