FOCUS超声刀在甲状腺开放手术中的应用及技巧

目的 探讨在开放甲状腺手术中采用FOCUS超声刀操作的效果及技巧.方法 将拟行单侧甲状腺次全切除术的患者随机分为FOCUS超声刀组(n=94)和常规组(n=87),比较两组手术时间、术中失血量、术后早期并发症、术后疼痛VAS评分,随访3个月观察有无声音改变.结果 FOCUS超声刀组和常规手术组的手术时间分别为(57.2±12.3)min和(88.6±18.9)min(P<0.05),术中失血量分别为(39.3±21.7)ml和(78.6±39.2)ml(P<0.05);术后声音改变和出血的例数分别为2例、3例和0例、2例(P>0.05);术后24 h VAS疼痛评分,FOCUS超声刀组和常规手术组分别为3.1±0.5和4.7±0.9(P<0.05),术后48 h两组分别为2.1±1.1和2.7±0.8(P>0.05).随访3个月两组均无迟发型声音嘶哑病例.结论 FOCUS超声刀应用于开放甲状腺手术,具有缩短手术时间、减少出血及疼痛的优点;术者掌握FOCUS超声刀的使用技巧,手术更为便捷和安全.

The use of harmonic FOCUS during thyroidectomy and its surgical techniques

Objective To study the significance of Harmonic FOCUS in thyroid surgery and operative techniques.Methods 181 inpatients undergoing elective subtotal thyroidectomy were randomly assigned to FOCUS group（94 cases）and conventional group（87 cases）.The operation time,intraoperative blood loss and postoperative complications were compared,and the degree of postoperative pain was assessed by using Visual Analog Scale（VAS）.Voice change was observed in the 3 months follow-up.Results The mean operative times in FOCUS group and conventional group were（57.2±12.3）min vs.（88.6±18.9）min,respectively（P0.05）.Mean intraoperative blood loss in FOCUS group and conventional group were（39.3±21.7）ml vs.（78.6±39.2）ml,respectively（P0.05）.The complications such as voice change,postoperative hematoma showed no significant differences between the two groups.VAS at 24 hours postoperatively in FOCUS group and conventional group were 3.1±0.5 vs.4.7±0.9,respectively（P0.05）.There were no statistical differences among two groups at 48 hours,and there was no delayed voice change in the 3 months follow-up.Conclusions Use of the Harmonic FOCUS may reduce operation time,intraoperative blood loss and postoperative pain in open thyroidectomy.Mastering the techniques of FOCUS,surgery can be more convenient and safety.