双极电凝在甲状腺腺叶切除加Ⅵ区淋巴结清扫术中的应用

The application of bipolar coagulation forceps in open thyroid lobectomy and central lymph node(level Ⅵ) dissection

目的观察双极电凝在甲状腺腺叶切除加Ⅵ区淋巴结清扫术中的临床应用效果。方法回顾性分析2015年1月至2018年1月间我院收治的72例行开放甲状腺腺叶切除加Ⅵ区淋巴结清扫术的甲状腺乳头状癌患者临床资料,根据是否使用双极电凝分为双极电凝组(A组) 40例和单极电凝组(B组) 32例。采用SPSS 11. 0软件进行统计学分析,对两组患者手术指标比较采用t检验;手术并发症计数资料采用χ2检验,以P <0. 05为差异具有统计学意义。结果 A组手术时间(46. 4±7. 5) min显著短于B组(70. 8±11. 1) min; A组出血量(6. 0±3. 4) ml显著少于B组(15. 5±6. 0) ml,差异均有统计学意义(P <0. 01)。两组间切口长度、术后引流量和淋巴结清除个数等指标相比差异无统计学意义(P> 0. 05)。两组患者都没有术后出血病例,A组手术后并发症总发生率2. 5%显著低于B组15. 6%,差异有统计学意义(P <0. 05)。结论双极电凝是施行甲状腺腺叶切除加Ⅵ区淋巴结清扫术时的理想工具,具有较好的应用前景。

Objective To investigate the clinical result in open thyroid lobectomy and central lymph node（level Ⅵ） dissection using bipolar coagulation forceps. Methods The 72 cases of thyroid papillary carcinoma with open thyroid lobectomy and central lymph node（level Ⅵ） dissection treated in our hospital from Jan 2015 to Jan 2018 were divided into Group A （using bipolar coagulation forceps） and Group B （using monopolar coagulation） according to the different surgical instruments. The clinical data were recorded and compared between the two groups. SPSS 11.0 software was used for statistical analysis. The measurement data were compared by t test. The postoperative complication rates were examined by Chi／｜square . A P 〈0.05 was considered as significant difference. Results The mean operating time [46.4±7.5 ） min vs. （70.8±11.1） min], blood loss volume[（6.0±3.4） ml vs. （15.5±6.0） ml]. in Group A were significantly lower than those in Group B （P 〈0.01）. But the length of incision, drainage volume after operation, number of lymph node retrieved had no significant difference between the two groups （P 〉0.05）. No case of postoperative bleeding was found. The total incidence of postoperative complications （2.5% vs. 15.6%） in Group A was significantly lower than Group B （ P 〈0.05）. Conclusions The bipolar coagulation forceps is an ideal tool in open thyroid lobectomy and central lymph node（level Ⅵ） dissection.