多种能量器械在甲状腺癌手术应用中的对比分析

Comparative analysis of multiple energy equipments used in thyroid cancer surgery

目的对比分析直型双极电凝镊、Focus超声刀及高频电刀在甲状腺癌手术中的应用效果。方法选择2020年5月~2021年4月接受甲状腺癌标准根治术的病人165例,随机分为双极电凝组、超声刀组及电刀组,每组各55例。对三组病例一般资料、手术时间、术中出血量、术后引流时间、总引流量、术前、术后甲状旁腺素水平、血清钙离子水平、术后并发症发生率及单项费用进行对比分析。结果三组手术均成功完成;双极电凝组与超声刀组术后甲状旁腺素水平、血清钙离子水平、术后并发症发生率比较差异有统计学意义(P<0.05),其余指标差异无统计学意义(P>0.05),双极电凝组单项费用高于超声刀组;双极电凝组、超声刀组手术时间、术中出血量、术后引流时间、总引流量、术后甲状旁腺素水平、血清钙离子水平及并发症发生率均小于电刀组,差异有统计学意义(P<0.05),双极电凝组单项费用高于电刀组。结论三组能量器械均能顺利完成手术,达到治疗目的,在手术时间、术中出血量、术后引流时间、总引流量、术后甲状旁腺素、血清钙离子及并发症发生率方面直型双极电凝镊及Focus超声刀较高频电刀具有优势;在经济方面,直型双极电凝镊虽然稍高于高频电刀,但较Focus超声刀具有明显优势;在精细解剖方面,直型双极电凝镊具有优势。

Objective Comparative analysis of the application effects of straight bipolar coagulation forceps,Focus ultrasonic equipment and high frequency electrosurgical equipment in thyroid cancer surgery.Methods Select 165 patients accept standard radical resection of thyroid cancer from May 2020 to April 2021.Divide randomly into bipolar electrocoagulation group,ultrasonic equipment group and electrosurgical equipment group,with 55 cases in each group.The general patient’s information of the three groups are operation time,intraoperative blood loss,postoperative drainage time,total drainage,preoperative and postoperative parathyroid hormone value,serum calcium ion value,postoperative complication rate and individual costs.This study conducts a comparative analysis of these indicators.Results The three groups of operations were successfully completed;the bipolar electrocoagulation group and the ultrasonic equipment group have significant differences in the postoperative parathyroid hormone value,serum calcium ion value,and postoperative complication rate,and they were statistically significant(P<0.05),the rest of the indicators were not statistically significant(P>0.05).Among them,the single cost of the bipolar electrocoagulation group is higher than that of the ultrasonic equipment group.The first two groups are compared with the electrosurgical equipment group and find that the operation time,intraoperative blood loss,and postoperative Drainage time,total drainage volume,postoperative parathyroid hormone value,serum calcium ion value,and complication rate are all lower than those in the electrosurgical group,the difference was statistically significant(P<0.05),and the individual cost is higher than that in the electrosurgical group.Conclusion All three groups of energy devices can successfully complete the operation and achieve the treatment goals.In the operation time,intraoperative blood loss,postoperative drainage time,total drainage,postoperative parathyroid hormone value,serum calcium ion value and complications In terms of efficiency,straight bipolar coagulation forceps and Focus ultrasonic scalpel have advantages in higher frequency electrosurgical units.In terms of economy,straight bipolar coagulation forceps are slightly higher than high frequency electrosurgicals,but they have obvious advantages over Focus ultrasonic scalpels.Straight bipolar coagulation forceps has an absolute advantage in fine anatomy.