Focus超声刀在桥本氏甲状腺炎并甲状腺乳头状癌手术中的应用

Application of Hypercator(Focus) in the Operation of Hashimoto's Thyroiditis Complicated with Papillary Thyroid Carcinoma

目的探讨Focus超声刀在桥本氏甲状腺炎(hashimoto’s thyroiditis,HT)合并甲状腺乳头状癌(papillary thyroid carcinoma,PTC)手术中的应用价值.方法选择2011年8月至2014年8月确诊的99例HT合并PTC患者,随机分成2组,研究组38例,对照组61例,进行Focus超声刀手术法与传统手术法在HT合并PTC手术中的临床应用对照研究,将2组各数据作统计学比较,结果显示Focus超声刀手术法的手术时间更短研究组为(92.26±12.39)min,对照组为(129.23±17.14)min,P<0.05,术中出血量更少,研究组为(45.37±7.86)m L,对照组为(68.26±17.15)m L,P<0.05,手术切口更小,研究组为(6.60±0.31)cm,对照组为(7.52±0.80)cm,P<0.05,而2种手术方法的术后引流量研究组为(69.03±11.02)m L,对照组为(71.59±14.00)m L,P>0.05,则无明显差异.超声刀手术法的术后并发症(研究组有3例出现术后并发症,2例为暂时性手足麻木,1例为声嘶)较传统手术法(照组有6例出现术后并发症,3例为暂时性手足麻木,2例为声嘶,1例为乳糜瘘)差异无统计学意义(P>0.05).结论 Focus超声刀用于HT合并PTC的手术中,可提高手术质量和效率,使手术切口缩小,而手术风险及并发症并未增加,具有较高临床应用价值.

Objective To investigate the value of harmonic scalpel （FOCUS） in Hashimoto＇s thyroiditis complicated with papillary thyroid carcinoma operation. Methods 99 cases of concommitant Hashimoto＇s thyroiditis and papillary thyroid carcinoma treated from Aug 2011 to Aug 2014 were selected and analyzed retrospectively. The 99 eases were randomly assigned to FOCUS group （38 cases） and conventional group （ 61 eases）. Results As compared with conventional group, FOCUS group was characterized by a shorter operative time （92.26 ±12.39 minutes VS 129.23 ± 17.14 minutes, P〈0.05）, less intraoperation blood loss （45.37 ± 7.86 mL VS 68.26 ± 17.15 mL, P〈0.05） and smaller incision （6.60 ±0.31 cm VS 7.52 ±0.80 cm, P〈0.05）. There was significant difference between two groups in the postoperative drainage volume （69.03 ± 11.02 mL VS 71.59 ± 14.00 mL, P〉0.05）. There were three patients presented with postoperative complications （2 cases were temporary numbness of hand and foot, 1 case had voice change） in FOCUS group, while there were six patients presented with postoperative complications （3 cases were temporary numbness of hand and foot, 2 cases had voice change, 1 case had Chylous Fistula）, so there was no significant difference between two groups in postoperativecomplication （P〉0.05）. Conclusion Using harmonic scalpel （FOCUS） in Hashimoto＇s thyroiditis complicated with papillary thyroid carcinoma operation can improve the operating efficiency and quality, reduce the incision, but risk and complications of surgical treatment were not increased. Harmonic scalpel （FOCUS） provides significant advantages in Hashimoto＇s thyroiditis complicated with papillary thyroid carcinoma operation.