甲状腺再次手术胸锁乳突肌内侧缘入路与颈白线入路手术方式的比较

Comparison of the medial sternocleidomastoid approach and linea alba cervicalis approach in thyroid reoperation

目的探讨甲状腺再次手术胸锁乳突肌内侧缘入路与颈白线入路手术方式的比较。方法选择甲状腺疾病再手术的患者共108例,根据手术入路方法分为研究组(n=50)和对照组(n=58),研究组采用胸锁乳突肌内侧缘入路,对照组采用颈白线入路。观察两组手术总时间、显露甲状腺的时间、术中出血量、术后住院天数、术后并发症发生情况等。结果研究组显露甲状腺时间显著早于对照组,手术总时间、术中出血量显著低于对照组,差异均有显著性(P<0.05)。两组住院时间无统计学差异(P>0.05)。两组患者术后均未出现严重并发症。结论对于甲状腺再手术的患者采用胸锁乳突肌内侧缘入路可获得相对较清晰的解剖层次,出血少,手术时间短,值得临床推广。

Objective To compare medial sternocleidomastoid approach and linea alba cervicalis approach in thyroid reoperation. Methods One hundred eight patients with thyroid disease reoperation were collected. According to surgical approach,they were divided into study group（ n = 50） and control group（ n = 58）. In the study group,the medial sternocleidomastoid approach was used; and in the control group,linea alba cervicalis approach was undertaken. The total operation time,exposing thyroid time,blood loss,postoperative hospital stay and postoperative complications were observed. Results The time for thyroid exposure and the total time of surgery in the study group were significant shorter than the control group（ P〈0. 05）. The blood loss was significantly less than the control group（ P〈0. 05）. No significant difference was found between the two groups in hospital stay. No serious postoperative complications were found. Conclusion For patients with thyroid reoperation,medial sternocleidomastoid surgical approach can get a relatively clear anatomical structures,less bleeding,shorter operative time.