经胸锁乳突肌前缘径路行甲状腺切除术的临床体会

目的探讨经胸锁乳突肌前缘入路行甲状腺切除在肿瘤手术中的临床价值。方法2008年8月-2010年6月间行甲状腺切除患者104例，随机分为观察组52例和对照组52例，观察组采用胸锁乳突肌前缘径路行甲状腺切除；对照组传统经颈白线入路切除。比较两组患者的手术时间、术中出血、术后引流量以及并发症等。结果两组病例手术均顺利，无术中大出血及喉返神经损伤。观察组平均住院时间、手术时间、术中出血、术后引流量较对照组减少（P〈0．01）；颈部功能恢复、颈部术口美观情况优于对照组（P〈0．05）。结论行胸锁乳突肌前缘径路甲状腺切除术暴露充分，操作方便，可减少出血及喉返神经损伤，能较好地满足患者对颈部切口的美观要求等优点。值得临床推广应用。

Clinical experience of sternocleidomastoid leading edge approach of thyroidectomy

Objective To evaluate the clinical value of leading edge of the sternocleidomastoid approach of thyroidectomy.Methods 104 patients underwent thyroidectomy from August 2008 to June 2010 were randomly assigned to observation group and control group.Patients in the observation group were treated with the sternocleidomastoid leading edge approach of thyroidectomy;patients in control group were treated with neck white line approach.Surgery time,blood loss,postoperative drainage and complications of the two groups were compared.Results Surgery went well in both groups,without massive hemorrhage and recurrent laryngeal nerve injury.Average length of hospital stay,operative time,blood loss and postoperative drainage reduced significantly in the observation group than that in the control group(P < 0.01);neck function recovery and neck incision cosmetic status were also enhanced in the observation group(P < 0.05).Conclusion The sternocleidomastoid leading edge approach of thyroidectomy has full exposure,it is easy to operate and can reduce bleeding and recurrent laryngeal nerve injury.It can also better meet cosmetic requirements of neck incision of patients which is worthy of clinical application.