Focus超声刀与传统方法在开放性甲状腺手术中的临床对比研究

Clinical Comparative Study of Focus Harmonic Scalpel and Conventional Techniques in Open Thyroidectomy

目的比较Focus超声刀与传统方法在开放性甲状腺手术中的应用效果。方法回顾性分析2015年6月至2016年9月内蒙古自治区人民医院收治的177例接受开放性甲状腺手术患者的临床资料,其中85例采用Focus超声刀行甲状腺手术(观察组),92例采用传统方法行甲状腺手术(对照组)。两组均由同一组医师团队施行手术,分别比较两组患者的手术时间、术中出血量、术后引流量及术后并发症发生情况。结果观察组的手术时间、术中出血量、术后引流量、切口长度均少于对照组[(83.89±21.57)min比(94.72±24.54)min,(49.67±24.10)m L比(76.22±34.91)m L,(65.35±32.00)m L比(82.66±33.76)m L,(7.24±1.01)cm比(7.78±1.35)cm](P<0.01)。两组患者术后活动性出血、喉返神经损伤、低钙麻木、切口感染及总并发症发生率比较差异均无统计学意义(P>0.05)。两组患者术前及术后24 h血清甲状旁腺激素及血清Ca2+比较差异均无统计学意义(P>0.05)。结论 Focus超声刀在甲状腺开放手术中缩短了手术时间,提供了更清晰的术野。与传统方法相比Focus超声刀不会增加术后并发症的发生率,具有良好的临床应用价值。

Objective To compare the application effect of Focus harmonic scalpel and conventional technique in open thyroidectomy. Methods The clinical data of 177 patients undergoing open thyroidectomy in Inner Mongolia People's Hospital from Jun. 2015 to Sep. 2016 were analyzed retrospectively. Of these patients,85 patients who underwent harmonic scalpel thyroidectomy were regarded as an observation group,92 patients who underwent conventional techniques of thyroidectomy were regarded as a control group. The two groups were operated by the same team of surgeons. The operation time,intraoperative blood loss,postoperative drainage and postoperative complications of the two groups were compared. Results The operative time,intraoperative blood loss,postoperative drainage and incision length of the observation group were all less than those of the control group[( 83. 89 ± 21. 57) min vs( 94. 72 ± 24. 54) min,( 49. 67 ± 24. 10) m L vs( 76. 22 ±34. 91) m L,( 65. 35 ± 32. 00) m L vs( 82. 66 ± 33. 76) m L,( 7. 24 ± 1. 01) cm vs( 7. 78 ± 1. 35) cm]( P < 0. 01). There was no statistically significant difference in the incidence of postoperative active bleeding,recurrent laryngeal nerve injury,low calcium numbness,incisional infection,and total complication rate between the two groups( P > 0. 05). There was no statistically significant difference of serum parathyroid hormone and serum Ca2 +in both groups before and 24 h after operation( P > 0. 05). Conclusion Focus harmonic scalpel shortens the operation time and provides clearer field for open thyroidectomy. Compared with the conventional technique,the incidence of postoperative complications is not increased,therefore it can be concluded to have good clinical value.