胸锁乳突肌内缘入路在单侧甲状腺手术中的应用

摘要

Objective To explore the clinical application of transthoracic approach to unilateral thyroidectomy under general anesthesia with tracheal intubation.Methods Twenty-seven patients with unilateral thyroidectomy from January 2013 to November 2016 in Wuhu First People's Hospital were retrospectively analyzed.27 patients underwent unilateral thyroidectomy (control group).The length of incision,blood loss,operation time,postoperative incision edema,postoperative hospital stay,postoperative swallowing discomfort,neck tightness and the rate of anterior cervical banded muscle were compared between the two groups.Results All patients underwent general anesthesia under tracheal intubation.There was no significant difference between the control group and the experimental group in the postoperative hospital stay (P>0.05).In the incision length,blood loss,operation time,postoperative incision edema,swallowing discomfort,neck tightness and neck,there is significant difference between the two groups (P<0.05).Conclusion The medial margin of the sternocleidomastoid muscle approach to unilateral thyroid surgery is effective,patients with small trauma,high quality of life,worthy of clinical application.%目的 探讨气管插管全身麻醉下采用经胸锁乳突肌内侧缘入路行单侧甲状腺手术的临床应用价值.方法 回顾性分析芜湖市第一人民医院2013 年1 月-2016 年11 月共为27 例经胸锁乳突肌内侧缘入路行单侧甲状腺手术病人(观察组)和同期27 例经颈白线传统手术入路行单侧甲状腺手术病人(对照组)临床资料,比较两组病人的手术切口长度、术中出血量、手术操作时间、术后切口水肿、术后住院天数及术后病人吞咽不适、颈部紧缩感及颈前带状肌切断率等情况.结果 两组病人均于气管插管全身麻醉下顺利完成手术.对照组与观察组术后住院时间比较差异无统计学意义(P>0.05);而在切口长度、术中出血量、手术操作时间、术后切口水肿、吞咽不适、颈部紧缩感及颈前带状肌切断率等方面比较,差异有统计学意义(P<0.05).结论 经胸锁乳突肌内侧缘入路行单侧甲状腺手术疗效确切,病人创伤小、生活质量较高,值得临床推广应用.