重视甲状腺疾病外科治疗新技术的规范化应用

Pay attention to the standardized application of new techniques in surgical treatment of thyroid disease

甲状腺外科领域的新技术不断出现并应用于临床,促进了甲状腺手术水平的快速提高.神经监测技术的诞生使甲状腺外科进入精准时代,术中间断神经监测技术和术中连续神经监测技术可更有效地保护喉返神经.纳米炭甲状旁腺负显影辨认保护技术的出现使甲状旁腺的保护更加精准,但应用纳米炭时需把握好注入时间、位置及剂量,以达到最佳的负显影效果.腔镜及机器人甲状腺手术满足了患者对美容的需求,但必须严格遵守“治病第一,美容第二”的原则,切勿盲目扩大适应证及片面追求腔镜术式.能量外科器械的不断更新使手术操作更加高效,同时也存在一定弊端,正确认识能量设备的工作原理并合理使用也是当前甲状腺手术必须重视的工作.临床实践中应掌握新技术的方法、原理及应用技巧,明确其优势及弊端,坚持“合理选择、规范应用”的原则,借鉴先行者使用经验,不断思考总结,确保甲状腺疾病诊疗中新技术的应用更加合理安全.

The continuous development and application of new technology in thyroid surgery has promoted the rapid improvement of thyroid surgery.New technology in the field of thyroid surgery has developed rapidly.The application of neural monitoring technology has enabled the thyroid surgery to enter an accurate era.Imtraoperative neuromonitoring and continuous intraoperative neuromonitoring have made the recurrent laryngeal nerve protection more secure.Nano-carbon parathyroid gland negative imaging technology could identify parathyroid gland more precise.However,when the nano-carbon was used,the injection time,position and dosage should be grasped so as to achieve the best effect of negative imaging.Endoscopic and robotic thyroid surgery could meet the demand of cosmetic.＂Treatment first,beauty second＂ is still the principle to be strictly followed.Do not blindly expand indications and pursue endoscopic surgery.Energy surgical instruments＇ update made the operation more efficient,while the instruments have some disadvantages.Thyroid surgeon must correctly understand the working principle of new energy devices and use them rationally.Through grasping the working principle and application skills of new technology in clinical work,definiting its advantages and disadvantages,adhereing to the ＂reasonable choice,standard application＂ principle,learning the pioneers＇ experience,the application of new thyroid diagnosis and treatment technology could be more reasonable and safe.