超声刀在甲状腺癌根治及颈淋巴结清扫术中的临床应用

目的探讨在甲状腺癌根治及颈淋巴结清扫术中使用超声刀的效果及安全性。方法甲状腺癌患者187例,超声刀组109例,用超声刀行甲状腺癌根治及颈淋巴结清扫术;电刀组78例,应用电刀行同样手术,均由同一手术组医生施行。分别比较两组的手术时间、切口长度、术后引流量及手术并发症(出血、喉返神经麻痹及甲状旁腺功能低下)发生率。结果超声刀组的切口长度、手术时间、住院天数均小于电刀组(P<0.05);而两组的术后引流量无统计学差异(P>0.05),两组术后暂时性甲状旁腺功能低下和喉返神经麻痹发生率差异无统计学意义(P>0.05),均无永久性甲状旁腺功能低下、喉返神经麻痹及术后出血病例。结论用超声刀行甲状腺癌根治及颈清扫术不仅有效安全,而且缩短手术时间、切口长度和住院时间。

Clinical application of harmonic scalpel in radical thyroidectomy and neck lymph dissection of thyroid carcinoma

Objective To investigate the safety and availability of harmonic scalpel in radical thyroidectomy and neck lymph dissection of thyroid carcinoma.Methods 109 patients and 78 patients underwent thyroid surgery with harmonic scalpel（HS group） or conventional hemostasis（CH group）,respectively.The incisional length,the total operative time,postoperative drainage volume and surgical complications（postoperative hemorrhage,recurrent laryngeal nerve palsy,hypoparathyroidism） were compared between the two groups.Results There was no significant difference between the HS and CH group at baseline.Incisional length,total operative time,and hospital days in HS group were significantly lower than those of CH group（P 0.05）.No significant difference was observed in postoperative drainage volume and the overall perioperative complications,such as temporary recurrent laryngeal nerve palsy and hypoparathyroidism,between the two groups（P 0.05）.No permanent recurrent laryngeal nerve palsy,hypoparathyroidism and postoperative hemorrhage happened.Conclusion The application of harmonic scapel in radical thyroidectomy and neck dissection of thyroid cancer is a effective and safe procedure.At the same time,the harmonic scapel significantly reduces the operating time,incisional length and duration of hospital stay.