目的 探讨单极喷凝联合Valsalva正压通气在开放性甲状腺切除术中止血的临床应用.方法 回顾性分析2013年1月至2016年12月于本院行开放性甲状腺切除术的724例患者的临床资料,按照术中止血方法不同将其分为单极喷凝组、Valsalva正压通气组、单极喷凝+Valsalva正压通气组、常规组,比较四组患者术后出血、声嘶及低钙血症发生率.结果 单极喷凝组、Valsalva正压通气组及单极喷凝+Valsalva正压通气组患者术后出血发生率均低于常规组(P<0.05),上述三组患者术后声嘶发生率及低钙血症发生率与常规组比较均无显著差异(P>0.05).结论 单极喷凝联合Valsalva正压通气用于开放性甲状腺切除术中止血,有利于降低术后出血发生率,具有一定的安全性和可行性.%Objective To investigate the clinical application of combination of monopole spray electroco-agulation with Valsalva positive pressure ventilation in hemostasis of open thyroidectomy. Method Clinical data of 724 patients underwent open thyroidectomy from January 2013 to December 2016 in our hospital were retrospectively analyzed, they were divided into monopolar spray electrocoagulation group, Valsalva positive pressure ventilation group, monopolar spray electrocoagulation + Valsalva positive pressure ventilation group and routine group according to different methods of hemostasis during the operation, the incidence rate of postoperative hemorrhage, hoarseness and hypocalcemia were compared among the four groups. Result The incidence rates of postoperative hemorrhage of monopolar spray electrocoagulation group, Valsalva positive pressure ventilation group and monopolar spray electrocoagulation + Valsalva positive pressure ventilation group were all lower than routine group (P < 0.05), there were no significant differences in incidence rates of hoarseness and hypocalcemia among the four groups (P>0.05). Conclusion Monopolar spray electrocoagulation combined with Valsalva positive pressure ventilation for hemostasis during open thyroidectomy is helpful to reduce the incidence of postoperative hemorrhage, and is safe and feasible.
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