超声刀在微创开放性甲状腺手术中的应用

摘要

Objective Minimally invasive surgery is characterized by minimal invasion, less pain and faster recovery. This study aimed to investigate the application value and operating skills of the harmonic scalpel in minimally invasive open thyroid surgery. Methods We performed open thyroid surgery for 56 patients using the harmonic scalpel (HS group) and for another 67 with the conventional electric scalpel (ES group). We compared the two groups in the incision size, intraoperative bleeding, operation time, postoperative drainage volume, necessity of drainage tube insertion, length of hospitalization, and complications. Results The HS group showed significantly smaller incision size, less intraoperative bleeding, shorter operation time, lower postoperative drainage volume, and fewer postoperative beddays than the ES group ( P < 0. 05 ) . But there were no statistically significant differences in the necessity of drainage tube insertion and postoperative complications between the two groups. Conclusion The use of HS in minimally invasive open thyroid surgery can evidently decrease the incision size, blood loss, operation time, postoperative drainage volume and length of hospitalization without increasing postoperative complications.%目的 微创手术有创伤小、患者痛苦少、术后恢复快等优点,在去除病灶的前提下尽量减少手术给患者带来的损伤,一直是外科医师追求的目标.文中就微创化的意义探讨超声刀在微创开放性甲状腺手术中的应用价值及其操作技巧.方法 超声刀完成微创开放性甲状腺手术56例(超声刀组),传统电刀完成甲状腺开放性手术67例(电刀组)；观察对比2组手术切口大小、术中出血量、手术时间、术后引流量及是否放置引流管、术后住院时间及术后并发症等指标. 结果 超声刀组患者的手术切口、手术出血量、手术时间、术后引流量以及术后住院时间均较电刀组明显减少,差异具有统计学意义(P＜0.05),是否放置引流管、术后并发症发生率2组差异无统计学意义. 结论 超声刀在微创开放性甲状腺手术中能显著缩短手术切口、减少术中出血量、明显缩短手术时间、减轻局部创伤反应、减少术后引流量和缩短术后住院时间,且不增加术后并发症,做到真正意义上的微创手术,值得临床推广.