经峡部径路行甲状腺手术的术式改进

Modified thyroidectomy by trans-isthmus approach

摘要:

目的:探讨经峡部径路行甲状腺手术的临床价值。
方法:回顾性分析10年间5 751例行甲状腺手术患者的临床资料。按手术方式分为两组：经峡部径路甲状腺切除术的3 288例为改良组;同期施行传统切除术式的2 463例为常规组。比较两种手术方式对手术时间、术中出血、术后引流及并发症的影响。
结果:改良组手术时间较常规组明显缩短(P<0.01)，术中出血量、喉返神经神经损伤率、术后气管局部不适及低钙血症的发生率明显减少(P<0.01)，术后引流量减少(P<0.05)，患者对手术耐受性好，术后出血发生率两组无统计学差异。
结论:经峡部径路行甲状腺手术可明显缩短手术时间;减少术中出血量，以及降低喉返神经损伤、术后出血、低钙血症等并发症的发生。

Abstract:

Abstract:Objective:To analyze the clinical significance of modified thyroidectomy by trans-isthmus approach.
Methods :The clinical data of 5 751 patients who underwent thyroidectomy from Jan.1996 to Jan.2006 were retrospectively analyzed. All cases were divided into two groups. The modified operation group (n=3288) was treated by trans-isthmus thyroidectomy. Another group (n=2463) was treated by routine approach. The operation time, bleeding volume, and complications were observed and compared.
Results:In modified operation group, the mean operation time, bleeding volume, temporary injury of recurrent laryngeal nerve, tracheal discomfort, and hypocalcemia were significantly decreased than those in routine approach group (P<0.01). The patients in the modified operation group tolerated the operation better as compared to the routine approach group. There was no statistical difference in postoperative bleeding between the two groups.
Conclusions:The modified thyroidectomy by trans-isthmus approach could obviously decrease the operation time, bleeding volume, and rate of injury of recurrent laryngeal nerve and hypocalcemia.