膜解剖在甲状腺手术中的应用

Membrane Anatomy in Thyroid Surgery

目的探讨膜解剖技术在甲状腺手术中的应用效果。方法选取2021年9月至2022年9月内蒙古科技大学包头医学院第一附属医院收治的60例行甲状腺肿瘤根治手术的患者作为研究对象,其中30例采用电刀(即单极电凝)行常规手术作为对照组,30例采用双极电凝行膜解剖手术作为实验组。对比两组患者术中出血量、手术时间、术后第1日引流量,采用ELISA法检测术后1周的甲状旁腺激素和血钙水平,统计术后并发症的发生率。结果实验组术中出血量(15.35±3.26)mL明显少于对照组(36.53±5.18)mL,差异有统计学意义(P<0.05);实验组手术时间(42.14±3.34)min明显短于对照组(58.42±5.20)min,差异有统计学意义(P<0.05);实验组术后第1日引流量(31.16±4.68)mL与对照组(32.56±4.79)mL相比差异无统计学意义(P>0.05);实验组术后并发症发生率(16.7%,5/30)低于对照组(43.3%,13/30),差异有统计学意义(P<0.05)。结论基于膜解剖技术进行甲状腺手术,能够更好地保护甲状旁腺及喉返神经功能,显著缩短手术时间,减少术中出血量,降低并发症发生风险。

Objective To investigate the effect of membrane dissection technique in thyroid surgery.Meth⁃ods Between September 2021 and September 2022,A total of 60 patients treated with radical thyroid tumor surgery at the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology were selected as the study subjects.30 patients underwent conventional surgery with electrodebrider(monopolar electrocoagulation)as the control group,and 30 patients underwent membrane dissection surgery with bipolar electrocoagulation as the experimental group.The intraoperative bleeding,operating time,and postoperative drainage on the first day were compared between the two groups,and the parathyroid hormone and blood calcium levels were measured by ELISA 1 week after the operation.Results Intraoperative bleeding was significantly less in the experimental group than in the control group(15.35±3.26)vs.(36.53±5.18)mL,with a statistically sig⁃nificant difference(P<0.05);the operative time was significantly shorter in the experimental group than in the control group(42.14±3.34)vs.(58.42±5.20)min,with a statistically significant difference(P<0.05).The difference between the two groups was not statistically significant(P>0.05)when compared with the postoperative day 1 drainage flow(31.16±4.68)vs.(32.56±4.79)mL;the incidence of postoperative complications in the experimental group was less than that in the control group[(16.7%,15/30)vs(43􀆰3%,13/30)],and the differ⁃ence was statistically significant(P<0.05).Conclusion Thyroid surgery based on membrane dissection technique can better protect the function of parathyroid glands and the recurrent laryngeal nerve,significantly shorten the op⁃eration time,reduce intraoperative bleeding,and decrease the risk of complications.Conclusion Thyroid surgery based on membrane dissection technique can better protect the function of parathyroid glands and laryngeal recur⁃rent nerve,significantly shorten the operation time,reduce intraoperative bleeding,and decrease the risk of com⁃plications.