小切口甲状腺腺叶切除术中超声刀无缝扎技术与传统缝扎技术比较研究

Small incision thyroid lobectomy, sutureless technique using harmonic focus scalpel versus conventional suture ligation technique

小切口甲状腺腺叶切除术中超声刀无缝扎技术与传统缝扎技术的对比摘要：目的：探讨超声刀无缝扎技术在小切口甲状腺腺叶切除术中的临床应用价值。方法：78名患者按照所采用的手术技术被随机分为两组：一组 39例术中采用超声刀无缝扎技术（超声刀组），另一组39例采用传统的电刀结合缝扎止血技术（传统组）。分别比较两组手术时间、术中出血量、术后引流量及并发症发生率。结果：超声刀组手术时间（48.5±10.3min vs 63.4±8.5min, p〈0.05],术后24h引流量（38．2±12．6）mL显著低于传统组（50．5±12．1）mL，P〈0．05]，但两组术中出血量[（10．5±4．2）mL vs（11．2±5．6）mL，P〈0．05]，无统计学差异。两组均无术后喉返神经麻痹、术后出血发生。结论在小切口甲状腺腺叶切除术中，超声刀无缝扎技术能缩短手术时间且不增加术后并发症的发生率，由于其安全便捷可代替传统缝扎技术，具有较好的临床应用价值。

Small incision thyroid lobectomy： Conventional Suture Ligation technique versus sutureless techniques using Harmonic Focus Scalpel Aim： Harmonic Focus scalpel is an ultrasonic device developed most recently for thyroid surgery. The aim of this study was to evaluate the effectiveness of the Harmonic FOCUS scalpel in patients undergoing small incision thyroid lobectomy. Methods： In this study, 78 patients were randomized into 2 groups based on the surgical technique used： One group was treated by Harmonic Focus scalpel （HF） and one by Conventional Dissection （CD）. The groups were compared in regard to surgical time, intraoperative bleeding, drainage volume, and complications. Results： Compare with CD group, there was significantly faster operative time （48.5±10.3min vs 63.4±8.5min, p〈0.05]and postoperative drainage volume [ （38.2± 12.6） mL vs （ 50.5± 12.1 ） mL, P〈0.05] in the HF group. Intraoperative blood loss were similar between the two groups [（10.5±4.2） mL vs （11.2±5.6） mL]. No laryngeal recurrent nerve paralysis or postoperative bleeding occurred in the two groups. Conclusion Sutureless technique using harmonic focus scalpel is a fast and safe alternative to conventional suture ligation technique and does not increase postoperative complication rate, showing high clinical values.