超声刀在甲状腺癌颈淋巴结清扫术中的应用研究

Harmonic scalpel in cervical lymph node dissection of thyroid cancer

目的:探讨甲状腺癌颈淋巴结清扫中应用超声刀行清扫术与传统手术的优、缺点。方法:收集2009年至2010年间我院同一手术小组完成甲状腺癌颈清扫术55例,分为超声刀组(29例)和传统组(26例)。超声刀组行超声刀甲状腺癌颈淋巴结清扫术,传统组行传统淋巴结清扫术,分别比较两组的总手术时间、切除甲状腺时间、术后引流量及手术并发症的发生情况。结果:两组患者在性别、年龄方面差异无统计学意义(P>0.05)。超声刀组的总手术时间、切除甲状腺时间和术后引流量均小于传统组(P<0.05);两组术后暂时性甲状旁腺功能低下和喉返神经麻痹发生率差异无统计学意义(P>0.05),均无永久性甲状旁腺功能低下、喉返神经麻痹及术后出血病例。结论:用超声刀行甲状腺癌颈清扫术安全可靠,而且可缩短手术时间,减少术后引流量,减少手术并发症的发生,从而减少创伤,值得在临床中进行推广。

Objective：To compare the disadvantage and advantage of cervical lymph node dissection of thyroid cancer using the harmonic scalpel vs conventional hemostasis.Methods：Twenty-nine and twenty-six patients underwent thyroid surgery with harmonic scalpel or conventional hemostasis respectively.The total operative time,thyroidectomy time,postoperative drainage volume and surgical complications were compared.Results：There was no significant different of age and gender between the harmonic scalpel and conventional hemostasis group.Total operative time,thyroidectomy time,and postoperative drainage volume in harmonic scalpel group were significantly lower than those of conventional hemostasis group（P〈0.05）;the surgical complications showed no significant difference between the harmonic scalpel group and conventional hemostasis group（P〈0.05）.Conclusion：Harmonic scalpel provides significant advantages over conventional hemostasis in cervical lymph node dissection of thyroid cancer.