摘要
目的:探讨甲状腺癌中心区淋巴结清扫术中应用超声刀行清扫术及传统手术方法的优、缺点。方法:将本院2009年1月至2013年12月采用传统手术方式行甲状腺癌中心区淋巴结清扫术的35例患者设为传统手术组,应用超声刀实施甲状腺癌中心区淋巴结清扫术的40例患者设为超声刀组,比较两组患者的手术效果,术前、术后3 d血清甲状旁腺素、血钙及血磷水平,观察甲状旁腺功能损伤患者治疗及随访结果。结果:超声刀组患者手术时间、术中出血量、术后引流量、平均住院时间均少于(或短于)传统手术组(P<0.05),超声刀组低钙血症、血钙下降的发生率均低于传统手术组(P<0.05)。术前两组患者血清甲状旁腺素、血钙、血磷比较,差异均无统计学意义(P>0.05);术后传统手术组血清甲状旁腺素、血钙水平降低,血磷水平升高(P<0.05),表明传统手术组患者甲状旁腺功能损伤;超声刀组患者手术前后甲状旁腺功能无明显下降。术后3个月内,所有患者甲状旁腺功能恢复至正常范围,无永久性甲状旁腺功能减退的发生。结论:用超声刀行甲状腺癌中心区淋巴结清扫术安全可靠,而且可以缩短手术时间,减少术后引流量和手术并发症的发生,值得在临床中进行推广。
Objective： To compare the advantage and disadvantage of harmonic scalpel vs conventional operation mode in certer lymph node dissection of thyroid cancer. Methods：Thrity-five cases of thyroid operation from Jan 2009 to Dee 2013 were selected as conventional operation mode group, and they were given traditional operation mode. Forty cases of thyroid operation from Jan 2009 to Dec 2013 were selected as harmonic scalpel group, and they were operated by ultrasonic scalpel. Operation effect and efficiency, serum parathyroid hormone, calcium and phosphorus levels before and 3 days after operation were compared between the two groups, and curative effect and follow-up results were observed in patients with parathyroid function injury. Results：Operation time, intraoperative bleeding volume, postoperative drainage volume, average hospitalization time of harmonic scalpel group were all less than those of conventional operation mode group （ P 〈 0. 05 ）. Incidence of hypocalcemia, low serum calcium of harmonic scalpel group were lower than those of conventional operation mode group （ P 〈 0. 05 ）. There was no statistical difference on serum parathyroid hormone, serum calcium, phosphorus between the two groups before treatment. After operation, conventional operation mode group＇s serum parathyroid hormone and calcium level reduced, yet serum phosphate level were increased （P 〈 0. 05 ）, and harmonic scalpel group＇s parathyroid gland function was stable before and after operation. In 3 months after operation, all patients with parathyroid function injury were all recovered to normal range, and without permanent hypoparathyroidism. Conclusion： Harmonic scalpel group provides significant advantages over conventional operation mode group in certer lymph node dissection of thyroid cancer, harmonic scalpel is safe and reliablein certer lymph node dissection of thyroid cancer, it can shorten the operation time, reduce postoperative flow and the occurrence of surgical complications, is worth popularizing in clinical.
出处
《现代医学》
2014年第11期1332-1335,共4页
Modern Medical Journal
