医用透明质酸钠预防甲状腺术后切口粘连的有效性和安全性

目的:观察医用透明质酸钠预防甲状腺术后切口粘连的有效性和安全性。方法:用前瞻性临床随机对照研究的方法,入选2007年2-9月间我院与温州医学院附属第一医院肿瘤外科所做的各类甲状腺手术335例。其中,实验组166例,于切除甲状腺病灶后,取医用透明质酸钠3～5mL均匀涂抹于甲状腺创面、颈前肌群深面以及颈阔肌深面;对照组169例,创面未涂抹医用透明质酸钠。结果:实验组术后发生皮下积液18例(10.8%),对照组发生皮下积液13例(7.7%),两组间差异无显著性(P=0.32)。实验组无一例发生对该药物的过敏或异物排斥反应。实验组术后6个月发生各类颈部粘连19例(11.4%),对照组43例(25.4%),术后6个月颈部B超检查,实验组同步移动27例,不同步移动138例;对照组同步移动76例,不同步移动91例,两组间差异均有统计学意义(P<0.01)。结论:医用透明质酸钠能有效地降低甲状腺手术后颈部粘连,并不增加手术并发症。

Efficacy and Safety of Sodium Hyaluronate for Preventing Post-thyroidectomy Adhesion: A Randomized Clinical Trial

Objective To assess the efficacy and safety of sodium hyaluronate in preventing post-thyroidectomy adhesion. Methods Between February 2007 and September 2007, all patients requiring thyroidectomy according to the inclusion criteria were randomized to using sodium hyaluronate group and control group. A total of 335 patients were included in the randomized clinical trial including 166 cases of experimental group and 169 cases of control group. Results The incidence of subcutaeous pyema in sodium hyaluronate group (18 cases) was similar compared with control group (13 cases) (P=0.32). No case generated allergy or foreign bodies reject reaction in sodium hyaluronate group. The incidence of adhesion in sodium hyaluronate group (19 cases) was significantly fewer than control group (43 cases) (P<0.01). The Doppler showed that there were 138 cases derangement motion and 27 cases timing motion in sodium hyaluronate group after six months of operation, but in control group there were 91 cases DM and 76 cases TM with significant difference ( P<0.01). Conclusion Sodium Hyaluronate could efficiently decrease the post-thyroidectomy adhesion, and could not increase the incidence of postoperative complications.