几丁糖与透明质酸钠预防甲状腺术后粘连效果的对比研究

A comparative study of chitosan and sodium hyaluronate in prevention of tissue adhesion after thyroid operation

目的：对比研究几丁糖与透明质酸钠防止甲状腺术后粘连的效果。方法：对146例甲状腺疾病患者进行手术治疗,根据术中处理方法的不同,将其随机分成几丁糖组（术后创面涂2%几丁糖）56例、透明质酸钠组（术后创面涂1%透明质酸钠）52例、对照组（术后创面无任何处置）38例。手术后7 d出院,通过随访观察手术切口的凹陷程度以及吞咽异物感的程度来评定几丁糖和透明质酸钠预防术后粘连的效果。结果：随访时间1~6个月,平均3.5个月。几丁糖组术后发生粘连4例（7.1%）,透明质酸钠组术后发生粘连10例（19.2%）,对照组术后发生粘连19例（50.0%）。经统计学分析,几丁糖、透明质酸钠两组之间发生术后粘连的比例差异无统计学意义（P〉0.05）,而几丁糖、透明质酸钠两组发生术后粘连的比例均小于对照组,差异有统计学意义（P〈0.01）。结论：几丁糖与透明质酸钠均具有明显的防止甲状腺术后粘连的作用。

Objective： To evaluate the curative effect of chitosan and sodium hyaluronate in prevention of tissue adhesion after thyroid operation.Methods： From December 2008 to December 2009,146 patients were performed thyroid operation.The patients were randomly divided into 3 groups： group A（56 cases） was given chitosan,group B（52 cases） was given sodium hyaluronate while group C（38 cases） was given nothing after operation.Every patient was got out of the hospital seven days after operation.All the cases were observed for their adhesion of cutting edge six months after operation.Results： Tissue adhesion in group A was 4（7.1%）,group B was 10（19.2%） while group C was 19（50%）.There were insignificant differences between group A and group B（P0.05）,while there were significant differences between group A and group C,group B and group C（P0.01）.Conclusion： Chitosan and sodium hyaluronate can prevent tissue adhesion caused by thyroid operation.