超声刀与高频电刀对甲状腺切除患者生活质量的影响

Effect of Harmonic Scalpel and High-Frequency Electrosurgical Generator on the Quality of Life of Patients Underwent Thyroidectomy

目的:探讨超声刀与高频电刀对甲状腺切除患者生活质量的影响。方法:将因甲状腺肿物择期需行甲状腺手术患者60例随机分组,将30例术中经超声刀实施手术者作为超声刀组,另30例术中使用高频电刀者作为高频电刀组,比较两组手术情况和术后并发症;术后3个月对所有患者进行随伤,使用美容效果评分表(NSS)评价患者的美容效果,采用简明SF-36生活质量调查表,评估患者生活质量。结果:超声刀组腺叶切除术患者与次全切除术患者的手术时间、术中出血量、切口长度、术后引流量和住院时间均显著短于高频电刀组,差异有统计学意义(P<0.05);超声刀组术后并发症总发生率低于高频电刀组,两组比较差异有统计学意义(P<0.05);超声刀组满意度高于高频电刀组,两组比较差异有统计学意义(P<0.05);术后3个月,超声刀组患者生理职能、活力、社会功能、情感职能和精神健康评分均显著高于高频电刀组(P<0.05);两组随访3~36月,均未出现甲状腺肿物复发。结论:超声刀较高频电刀更具微创、手术时间短、恢复快、术后并发症少、美容效果好的优点,可显著提升患者生活质量,适于临床推广应用。

Objective： To investigate the effect of harmonic scalpel and high-frequency electrosurgical generator on the quality of life of patients underwent thyroidectomy. Methods： A total of 60 patients with thyroid neoplasms due for elective thyroid surgery were equally divided into two groups,30 in each. Patients scheduled for harmonic scalpel were group A,while patients scheduled for high-frequency electrosurgical generator were group B. The surgical effect,postoperative complications,cosmetic effect and follow-up conditions were compared. Results： The surgical time,intraoperative blood loss,length of incision,postoperative drainage volume and length of hospital stay of group A（ including adenoidectomy patients and total excision/subtotal resection patients） were significantly shorter or less than those of group B（ P〈0. 05）. The total incidence of postoperative complications of group A was lower than group B,difference were statistically significant（ P〈0. 05）; cosmetic satisfaction rate in group A were higher than that of group B,difference were statistically significant（ P〈0. 05）. 3 months after surgery,the scores of physiological function,vitality,social function,emotional function and mental health were significantly higher in group A than group B（ P〈0. 05）. There was no recurrence of thyroid neoplasms in the two groups during 3 to36 months of follow-up. Conclusion： The harmonic knife has advantages of minimaly invasive,shorter surgical time,fast recovery,few postoperative complications and good cosmetic effect. It can significantly improve the quality of life of patients and is suitable for clinical application.