超声刀与传统电刀对甲状腺手术术后切口炎性反应的临床研究

Clinical study of impact of harmonic scalpel and conventional electrotome on postoperative incision inflammatory reactions of patients undergoing open thyroid surgery

目的探讨超声刀与传统电刀对开放甲状腺手术术后切口炎性反应的影响。方法选取2014年12月-2016年6月370例开放甲状腺手术患者,随机分为观察组(超声刀组)190例,对照组(电刀组)180例;比较两组患者手术切口炎性反应及肿胀程度、术后切口渗出量、切口疼痛评分、愈合时间、长度、愈合等级、手术时间、术中出血量、住院时间及患者满意度。结果观察组在手术切口炎性反应及肿胀程度、切口渗出量、切口疼痛评分方面均优于对照组,两组比较差异有统计学意义(P<0.05);观察组切口愈合时间(4.53±0.94)d、切口长度(4.31±0.90)cm、切口愈合等级方面均优于对照组;观察组手术时间(38.54±4.76)min、住院时间(3.61±0.79)d均短于对照组,两组比较差异有统计学意义(P<0.05);术中出血量观察组(17.35±3.52)ml少于对照组(26.28±3.31)ml,两组比较差异有统计学意义(t=25.10,P<0.05);观察组患者满意度评分为(99.84±0.46)亦高于对照组(93.50±6.87),两组比较差异有统计学意义(t=12.36,P<0.05)。结论超声刀在开放甲状腺手术中能够明显减轻手术后切口炎性反应及肿胀程度,减少术中出血量及术后切口渗出量,减低切口疼痛程度,降低切口感染率,缩短患者手术时间、切口愈合时间及住院时间,减轻患者痛苦,提高患者满意度;使用超声刀在开放甲状腺手术中优于传统组使用电刀对术后切口愈合的影响,具有较好的临床应用价值。

OBJECTIVE To explore the impact of harmonic scalpel and conventional electrotome on postoperative incision inflammatory reactions of patients undergoing open thyroid surgery.METHODS A total of 370 patients who underwent the thyroid surgery from Dec 2014 to Jun 2016 were enrolled in the study and randomly divided into the observation group（the harmonic scalpel group）with 190 cases and the control group（the electrotome group）with 180 cases.The surgical incision inflammatory reactions,swelling degree,postoperative incision exudation volume,incision pain score,healing time,length of incision,incision healing classification,operation duration,intraoperative bleeding volume,length of hospital stay and patients′ satisfaction were observed and compared between the two groups of patients.RESULTS The surgical incision inflammatory reactions,swelling degree,incision exudation volume and incision pain score of the observation group were significantly better than those of the control group（P〈0.05）.The incision healing time of the observation group was（4.53±0.94）days,shorter than that of the control group;the length of incision of the observation group was（4.31±0.90）cm,shorter than that of the control group;the grade of incision healing of the observation group was higher than that of the control group.The operation duration of the observation group was（38.54±4.76）min,shorter than that of the control group,and the length of hospital stay of the observation group was（3.61±0.79）days,shorter than that of the control group,and there was significant difference between the two groups（P〈0.05）.The intraoperative bleeding volume of the observation group was（17.35±3.52）ml,less than（26.28±3.31）ml of the control group,and there was significant difference between the two groups（t=25.10,P〈0.05）.The score of patients′ satisfaction of the observation group was（99.84±0.46）points,higher than（93.50±6.87）points of the control group,and there was significant difference between the two groups（t=12.36,P〈0.05）.CONCLUSION As for the patients undergoing the open thyroid surgery,the harmonic scalpel can significantly alleviate the degree of postoperative incision inflammatory reactions and swelling,reduce the intraoperative bleeding volume and postoperative incision exudation volume,reduce the degree of incision pain,reduce the incidence of incision infections,shorten the operation duration,incision healing time and length of hospital stay,relieve the patients′ sufferings and improve the patients′ satisfaction.The harmonic scalpel is superior to the conventional electrotome in the postoperative incision healing of the patients undergoing the open thyroid surgery,and it has high clinical application value.