胸锁乳突肌内缘入路在单侧甲状腺手术中的应用

Application of internal approach of sternocleidomastoid muscle in unilateral thyroid surgery

目的探讨气管插管全身麻醉下采用经胸锁乳突肌内侧缘入路行单侧甲状腺手术的临床应用价值。方法回顾性分析芜湖市第一人民医院2013年1月—2016年11月共为27例经胸锁乳突肌内侧缘入路行单侧甲状腺手术病人(观察组)和同期27例经颈白线传统手术入路行单侧甲状腺手术病人(对照组)临床资料,比较两组病人的手术切口长度、术中出血量、手术操作时间、术后切口水肿、术后住院天数及术后病人吞咽不适、颈部紧缩感及颈前带状肌切断率等情况。结果两组病人均于气管插管全身麻醉下顺利完成手术。对照组与观察组术后住院时间比较差异无统计学意义(P>0.05);而在切口长度、术中出血量、手术操作时间、术后切口水肿、吞咽不适、颈部紧缩感及颈前带状肌切断率等方面比较,差异有统计学意义(P<0.05)。结论经胸锁乳突肌内侧缘入路行单侧甲状腺手术疗效确切,病人创伤小、生活质量较高,值得临床推广应用。

Objective To explore the clinical application of tran sthora cicapproach touni latera l thyroidectomyunder general anesthes ia with tracheal intubation. Methods Twenty-seven pat ients with unilatera l thyroidectomy from Jan ua ry 2013 to November 201 6 in Wuhu First Peopled Hospital were retrospectively analyzed. 27 patients underwent unilateral thyroidectomy （control group）. The length of in-cision, blood loss, operation time, postoperative incision edema, postoperative hospital stay, postoperative swallowing discomfort, neck tightness and the rate of anterior cervical banded muscle were compared between the two groups. Results All pat ien ts underwent gen-eral anesthesia under tracheal intubation. There was no significant difference between the control group and the experimental group in the postoperative hospital stay （P〉0. 05）. In the incision length, blood loss, operation time, postoperative incision edema, swallowing discomfort,neck tightness and neck,there is significant difference between the two groups （P 〈 0 .05 ） . Conclusion The medial mar-gin of the sternocleidomastoid muscle approach to unilateral thyroid surgery is effective,patients with small trauma,high quality of life, worthy of clinical application.