滴水双极电凝镊与超声刀在甲状腺手术中保护甲状旁腺的应用比较

目的:比较滴水双极电凝镊与超声刀在甲状腺手术中保护甲状旁腺的应用.方法:对我院2015年7月至2016年12月期间收住院的72例甲状腺手术患者分为研究组和对照组,研究组用滴水双极电凝镊手术,即滴水双极电凝镊组,对照组用超声刀手术即超声刀组.两组患者手术均由相同组医生进行.对两组患者的手术时间、术中出血量、术后引流量、术后出血、术后甲状旁腺素水平进行比较.结果:滴水双极电凝镊组病例36例,超声刀组36例.两组患者在年龄、性别、疾病构成及甲状腺结节大小方面比较差异均无统计学意义(P>0.05);滴水双极电凝镊组术中出血量和手术时间与超声刀组差异无统计学意义(P>0.05);滴水双极电凝镊组术后引流量低于超声刀组,差异具有统计学意义(P<0.05);滴水双极电凝镊组术后暂时性甲状旁腺功能低下发生率低于超声刀组,差异具有统计学意义(P<0.05);滴水双极电凝镊组和超声刀组均无术后出血及永久性甲状旁腺功能减低.结论:滴水双极电凝镊在行甲状腺手术中对甲状旁腺保护作用要优于超声刀.

Comparison of Application of Dripping Bipolar Electrocoagulation Forceps and Ultrasonic Scalpel in Protecting Parathyroid Glands During Thyroid Surgery

Objective:To compare the effect of using the drip bipolar coagulation forceps versus harmon-ic scalpel to protect parathyroid glands in thyroid surgery. Methods:Seventy two patients indicated for thyroid surgery were divided into two groups: the drip bipolar coagulation forceps group underwent surgery, the har-monic scalpel respectively. All operations were performed by the same group of doctors. The total operation time, intraoperative bleeding, postoperative drainage, and postoperative hypoparathyroidism were compared. Results:There were 36 valid cases in the drip bipolar coagulation forceps group,and 36 cases in the harmonic scalpel group. There were no significant differences between two groups in patients of age, gender disease com-position, and thyroid nodule diameter(P>0.05).Also the total operation time,intraoperative bleeding make no differences(P>0.05). The postoperative drainage of the drip bipolar coagulation forceps group was less than that of harmonic scalpel group ( P<0.05) . The incidence of transient postoperative hypoparathyroidism in the drip bipolar coagulation forceps group were significantly lower than those in the harmonic scalpel group( P<0. 05).Both groups do not exist patient of postoperative bleeding and permanent postoperative hypoparathyroid-ism. Conclusion:The drip bipolar coagulation forceps is better than the ultrasonic scalpel.