滴水双极电凝镊在甲状腺全切术中的临床应用

目的:探讨滴水双极电凝镊在甲状腺全切术中对甲状旁腺和喉返神经的保护作用.方法:将70例择期行甲状腺全切手术治疗的患者分为研究组和对照组,应用超声刀结合滴水双极电凝镊对研究组患者实施治疗,应用超声刀结合电刀及传统结扎方法对对照组患者实施治疗,对比两组患者手术时间、出血量、喉返神经损伤、术后甲状旁腺激素水平和血清钙值.结果:研究组患者的手术时间和出血量与对照组患者比较无明显差异,P>0.05.术后研究组患者的暂时性甲状旁腺功能低下和暂时性喉返神经麻痹的发生率分别为2.8%和5.7%,低于对照组的14.3%和17.1%,P<0.05,均无永久性甲状旁腺功能减低和永久性喉返神经麻痹的发生.结论:滴水双极电凝在甲状腺手术中应用,能够有效降低组织周围温度,有利于保护甲状旁腺血运和喉返神经.

Clinical Application of Drip Bipolar Coagulation in Thyroidectomy

Objective:To explore the effect of drip bipolar coagulation on parathyroid glands and recur-rent laryngeal nerve protection in thyroidectomy.Method:70 patients underwenttotalthyroidectomy were divid-ed into research group and control group. Patients in the research group were treated by harmonic scalpel and drip bipolar coagulation operation thyroidectomy, and patients in the control group were treated by harmonic scalpel operation thyroidectomy. The operative time, bleeding, palsy of recurrent laryngeal nerve, the blood calcium and postoperative PTH were compared between the two groups. Result:There was no difference of the operative time and bleeding in the two groups( P >0.05) . The complications of transient function insufficiency of parathyroid and transient palsy of recurrent laryngeal nerve were more in the control group (14.3% and 17. 1%) than in the research group (2.8% and 5.7%) with statistical difference (P<0.05). There were no per-manent function insufficiency of parathyroid and permanent palsy of recurrent laryngeal nerve in the two groups. Conclusion:Drip bipolar coagulation for thyroidectomy can effectively reduce the surrounding temper-ature of the tissue, and can protect the parathyroid and recurrent laryngeal nerve.