甲状腺再次手术胸锁乳突肌内侧缘入路与颈白线入路的临床探讨

Clinical discussion between secondary thyroidectomy by sternocleidomastoid medial edge approach and neck white line approach

目的:探讨胸锁乳突肌内侧缘入路在甲状腺再次手术中的临床优势。方法:回顾性分析2011年3月—2013年12月收治的甲状腺手术后复发患者120例,随机分为两组,胸锁乳突肌组(n=58例)实施经胸锁乳突肌内侧缘入路术式,颈白线组(n=62例)实施经颈白线入路术式。比较两组患者的手术时间、术中出血量、住院时间以及并发症等。结果:胸锁乳突肌组术中甲状腺充分暴露时间、完成整个手术时间、术中出血量和术后并发症发生率分别为(4.2±1.5)m in、(1.3±0.3)h、(15.8±5.1)m L和0,颈白线组为(6.3±2.2)m in、(1.6±0.5)h、(37.6±9.2)m L和6.5%,两组间差异均有统计学意义(P<0.05)。两组患者住院时间差异无统计学意义(P>0.05)。结论:甲状腺再手术时采用经胸锁乳突肌内侧缘入路能够暴露充分,操作方便,提高手术效率和安全性,值得临床推广应用。

Objective：To evaluate the clinical advantage of secondary thyroidectomy by sternocleidomastoid medial edge approach.Methods：Date of 120 secondary thyroidectomy patients were retrospectively reviewed.The patients were randomly divided into sternocleidomastoid group（n=58） and neck white line group（n=62）.Fully exposed time,operation time,bleeding loss and incidence of postoperative complications of the two groups were compared.Results：Fully exposed time,operation time,bleeding loss and the incidence of postoperative complications were reduced significantly in sternocleidomastoid group than those in neck white line group.There was significant difference between two groups（P〈0.05）.But there was no significant difference between hospital days of two groups of patients（P〉0.05）.Conclusion：The sternocleidomastoid medial edge approach is suitable for patients who need secondary thyroidectomy.It is worthy of clinical application since it can reduce bleeding and clinical complications,improve the operation efficiency and safety.