内镜下甲状腺手术的护理探讨

目的：探讨小切口无气工作腔室内镜下甲状腺手术的护理方法、可行性、效果及手术中的护理特点。方法：颈前单-2cm小切口径路。借助外牵吊技术建立无气工作腔室，以高频超声刀剪作为主要操作器械，辅以特选吸引剥离器等，采用统一的整体护理。对196例甲状腺腺瘤和结节性甲状腺肿病人实施内镜甲状腺手术。结果：194例病人顺利完成手术。手术时间45-90分钟。术中出血量5～30ml，有2例因为出血失控转为开放手术，20例因冰冻病理证实为甲状腺癌而转为开放手术。结论：颈前小切口无气腔室内镜下甲状腺手术具有创伤小、出血少、住院时间短等优点。通过颈前小切口无气腔室内镜下甲状腺手术的实践说明。具有丰富的手术配合经验及娴熟的专业护理技能是该手术获得成功的重要因素之一。

Study on the nursing care of endoscopic thyroidectomy

Objective:To investigate the nursing method,feasibility and effect of minimally invasive video-assisted thyroidectomy and its nursing feature during the operation.Methods:A gasless working space was created with concentional retractor through 2 cm small incision on neck.All the patients with thyroid adenoma or nodular goiter received consecutively the endoscopic operation and were taken with whole nursing care.Results:All operations were finished successfully,and none of them was referred for open operation.The mean time of operation was from 45 to 90 minutes and the amount of bleeding was 5~30 ml during the operation.2 of them were referred for open operation due to uncontrollable bleeding,20 of them were referred for open operation due to thyroid carcinoma.Conclusion:Small incision on neck has the following features,such as little trauma,less bleeding,short time in hospital and so on.The operation is safe,feasible and effective.The professional nursing skill and refined coordination for operating nurse are the important successful factors.