超声刀在甲状腺肿瘤手术中的应用效果及安全性评价

Application and safety evaluation of ultrasonic scalpel in thyroid tumor surgery

目的探讨超声刀在甲状腺肿瘤手术中的应用效果及安全性评价。方法选择2015年6月至2018年6月手术治疗的甲状腺瘤手术患者100例为研究对象,按随机数字表法分为超声刀组和电刀组,每组患者各50例。电刀组给予常规的高频电刀切除,超声刀组患者给予超声刀手术切除。以SPSS 22.0进行数据处理与分析,组间术中术后各项指标、TSH、 PTH、 PCT水平等计量资料以■表示,独立t检验;并发症发生率采用χ~2检验,当P<0.05时差异有统计学意义。结果①超声刀组患者的手术时间、术中失血量、术后引流量、术后住院时间均低于电刀组(P<0.05)。②术前两组患者的血清促甲状腺激素(TSH)、血清甲状旁腺激素(PTH)、血清降钙素原(PCT)水平比较差异无统计学意义(P>0.05),治疗后超声刀组患者的TSH、PTH水平均高于电刀组,而PCT水平则低于电刀组(P<0.05)。③超声刀组患者术后并发症发生率为6.0%(3/50),低于电刀组患者22.0%(11/50),差异有统计学意义(P<0.05)。结论与常规电切术相比,超声刀手术切除甲状腺肿瘤的效果更为显著,能够降低患者术中出血量、缩短手术时间,术后恢复快,且手术并发症少,安全性高,可在临床上进一步推广应用。

Objective To investigate the application effect and safety evaluation of ultrasonic scalpel in thyroid tumor surgery. Methods From June 2015 to June 2018, 100 patients of thyroid tumor were divided into ultrasonic scalpel group and electric scalpel group according to random number table. Each group had 50 patients. Results(1) The operation time, blood loss, postoperative drainage and postoperative hospitalization time of the ultrasonic scalpel group were lower than those of the electric scalpel group(P<0.05).(2)There was no significant difference in serum TSH, PTH and PCT between the two groups before operation(P>0.05). After treatment, the levels of TSH and PTH in the ultrasonic scalpel group were higher than those in the electric scalpel group, but the levels of PCT in the ultrasonic scalpel group were lower than those in the electric scalpel group(P<0.05).(3)The incidence of postoperative complications in the ultrasonic scalpel group was 6.0%(3/50), which was lower than that in the electric scalpel group [22.0%(11/50)], and the difference was statistically significant(P<0.05).Conclusion Compared with the electric scalpel, ultrasonic scalpel surgery for thyroid tumors can reduce the amount of blood loss in patients, shorten the operation time, accelerate postoperative rehabilitation. It also has a certain protective effect on patients with thyroid function, and less complication, high safety, which can be further promoted in clinical application.