甲状腺切除术中双极电凝与钳扎止血的应用比较

Comparative study of bipolar electrocoagulation and traditional ligation used in thyroidectomy

目的探讨双极电凝法在甲状腺手术止血中的应用及其替代传统的血管钳扎法的可能性。方法甲状腺(单侧)行次全和全切手术患者78例,其中38例采用双极电凝法,40例采用传统钳扎法。统计术中出血量、术后第1天引流量、手术时间等进行比较。结果术中、术后出血量两组间无统计学差异,术后第1天引流量双极电凝组较钳扎组少。结节性甲状腺肿组中双极电凝组的手术出血量为(54±14)ml,钳扎组为(63±10)ml,两组间无统计学差异;术后第1天引流量双极电凝组较钳扎组少,有显著性差异(P<0.05)。钳扎组中1例甲状腺乳头状癌患者出现术后喉返神经麻痹并发症。两组均无甲状旁腺功能减退并发症。结论双极电凝法可缩短手术时间,减少术腔内的结扎线异物,减少医疗费用并使局麻开展甲状腺手术成为可能。

OBJECTIVE To study the feasibility of bipolar electrocoagulation substituting traditional ligation for hemostasis in thyroid operation. METHODS 78 patients underwent near total thyroidectomy and total thyroidectomy.In 38 patients bipolar electrocoagulation was used for hemostasis and in the other 40 patients ligation was used to treat broken vessels. The bleeding quantity in operation,the drainage of the first day after operation and the operation duration both groups were compared. RESULTS There was no significant difference in bleeding quantity between these 2 groups. The quantity of drainage was less in patients used bipolar electrocoagulation. The average bleeding quantity was （54±14） ml in bipolar electrocoagulation group, and （63±10） ml in ligation group. There was no significant difference between these 2 groups. The drainage of the first day after operation was statistically less in bipolar electrocoagulation group （P〈0.05） . One patient with thyroid papillary carcinoma in ligation group suffered recurrent laryngeal nerve paralysis after operation. There was no hypoparathyroidism in these 2 groups. CONCLUSION Using bipolar electrocoagulation the formation of foreign body from ligation may be avoided and local anesthesia in thyroid operation may also allowed, which could help to reduce the operation fee.