首页> 中文期刊> 《中国医药导报》 >Focus超声刀在开放性甲状腺手术中的应用及对甲状旁腺功能的影响

Focus超声刀在开放性甲状腺手术中的应用及对甲状旁腺功能的影响

         

摘要

Objective To discuss the application of Focus ultrasound knife on open hypothyroid operation and its influence on parathyroid function. Methods From June 2012 to June 2014, at Department of General Surgery, People's Hospital of Tiantal County, 80 patients with benign tumor of thyroid were selected and divided into observation group and control group randomly. The patients in observation group were given open hypothyroid operations with Focus ultrasound knife, while the patients in control group were given open hypothyroid operations with traditional electric scalpel. The length of incision, surgery time, intra-operative bleeding and postoperative dralnage of two groups were observed. Postoperative blood calcium levels of two groups were observed, and the influence on parathyroid function of postoperative patients in two operation ways were compared. Results The length of incision [(3.67±1.02)cm], surgery time [(58.74±10.76) min], intra-operative bleeding [(20.53±5.12) mL] and postoperative dralnage [(38.79±8.73) mL] in observation group were less than those in control group [(5.68±1.42) cm, (72.16±12.33) min, (58.22±13.12) mL, (85.42±15.14) mL], the differences were statistically significant (t = 2.37, 2.42, 5.34, 6.02, P < 0.05 or P < 0.01). After operation 3 d, calcium serum and parathormone levels of patients in in observation group [(1.93±0.23) mmol/L, (34.16±9.75) ng/L] and those in control group [(1.81±0.20) mmol/L, (25.46±7.14) ng/L] were less than those before the operation [(2.31±0.15) mmol/L, (44.15±10.35) ng/L, (2.28±0.17) mmol/L, (44.61±11.64) ng/L], the differences were statistically significant (t=2.14, 4.06, 3.68, 5.04, P<0.05 or P<0.01). and these in control group were less than those in observation group, the differences were statistically significant (t = 2.35, 2.08, P < 0.05). The incidence of parathyroid function damage in observation group (5.0%) was than lower that in control group (20.0%), the difference was statistically significant (χ² = 4.11, P < 0.05). Conclusion The application of Focus ultrasound knife on Open hypothyroid operation can achieve favorable effect with tiny incision, short operation time, small amount of intra-operative bleeding and fast postoperative recovery, meanwhile it can protect parathyroid glands during the operation and reduce the incidence of parathyroid function damage, it is a safe and effective operation method.%目的:探讨Focus超声刀在开放性甲状腺手术中的应用及对甲状旁腺功能的影响。方法选择2012年6月~2014年6月天台县人民医院普外科收治的80例甲状腺良性肿瘤患者,随机分为观察组与对照组,观察组采用Focus超声刀进行开放性甲状腺手术,对照组采用传统电刀进行开放性甲状腺手术治疗。观察两组患者切口长度、手术时间、术中出血量及术后引流量。观察两组患者术后血钙水平,比较两种手术方式对术后患者甲状旁腺功能的影响。结果观察组患者手术切口长度[(3.67±1.02)cm]、手术时间[(58.74±10.76)min]、术中出血量[(20.53±5.12)mL]及术后引流量[(38.79±8.73)mL]均明显少于对照组[(5.68±1.42)cm、(72.16±12.33)min、(58.22±13.12)mL、(85.42±15.14)mL],差异有统计学意义(t =2.37、2.42、5.34、6.02,P<0.05或P<0.01);术后3 d 观察组血钙和甲状旁腺激素水平[(1.93±0.23)mmol/L、(34.16±9.75)ng/L]、对照组[(1.81±0.20)mmol/L、(25.46±7.14)ng/L]均较术前[(2.31±0.15)mmol/L、(44.15±10.35)ng/L,(2.28±0.17)mmol/L、(44.61±11.64)ng/L]明显降低,差异有统计学意义(t =2.14、4.06、3.68、5.04,P<0.05或P<0.01),且对照组低于观察组,差异有统计学意义(t =2.35、2.08,P<0.05);观察组患者甲状旁腺功能损害发生率(5.0%)低于对照组(20.0%),差异有统计学意义(χ²=4.11,P<0.05)。结论开放性甲状腺手术中应用Focus超声刀具有手术切口小、手术时间短、术中出血少、术后恢复快等优点,同时还能在术中有效地保护甲状旁腺,减少甲状旁腺功能损害的发生,是一种安全有效的手术方式。

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