超声刀在老年性甲状腺手术中的应用效果

Clinical effects of Harmonic Scalpel used in elderly thyroid surgery

目的探讨超声刀在老年甲状腺手术中应用效果,旨在提高甲状腺手术效果。方法随机选取2011年6月~2015年6月我院手术治疗的老年甲状腺手术患者84例作为研究对象。根据治疗模式随机分为观察组和对照组,各42例,观察组采用超声刀,对照组用传统手术。比较两组患者的手术状况和术后喉返神经并发症的发生状况。结果超声刀组甲状腺手术者的手术时间和术中出血量分别为（88.05±20.45）min和（23.05±5.95）ml明显低于传统电刀组的（123.55±30.90）min和（42.52±9.87）ml,差异有统计学意义（P〈0.05）;而两组的术后引流量相当,差异无统计学意义（P〉0.05）;超声刀组发生永久性喉返神经损伤、暂时性喉返神经麻痹等并发症的发生率为2.38%,低于对照组的7.14%,然而两组并发症总发生率比较,差异无统计学意义（χ2=1.816,P=0.178）。结论老年甲状腺手术患者采用超声刀能够大大缩短手术时间,术野清晰,降低保护喉返神经相关并发症的发生率。

Objective To study the clinical effects of harmonic scalpel used in elderly thyroid surgery,aimed at improving the therapeutic effect.Methods 84 elderly thyroid surgery patients treated in our hospital from June 2011 to June2015 were randomly selected as subjects.All patients were randomly divided into scalpel group an control group according to treatment mode,42 in each group.Harmonic scalpel used in the scalpel group and control group treated with conventional surgery.The surgery status and recurrent laryngeal nerve complications in two groups were compared.Results The operation time,blood loss in harmonic scalpel group was（88.05±20.45）min and（23.05±5.95）ml respectively,significantly lower than those of（123.55±30.90）min and（42.52±9.87）ml in the control group,the differences between the two groups were statistically significant（P〈0.05）,and the difference in postoperative drainage between two groups was not statistically significant（P〉0.05）.The incidence of permanent recurrent laryngeal nerve injury and transient recurrent laryngeal nerve injury in harmonic scalpel group was 2.38%,significantly lower than 7.14% in the control group.And the difference of overall complications incidence was not statistically significant（χ2=1.816,P=0.178）.Conclusions Harmonic scalpel used in elderly thyroid surgery can greatly shorten the operation time and has better surgical field.It can protect the recurrent laryngeal nerve.