电凝钩在乳晕径路腔镜甲状腺手术中的临床应用

目的：探讨电凝钩在乳晕径路腔镜甲状腺手术中应用的可行性和优点。方法：2002年8月到2005年5月采用胸部乳晕入路行腔镜甲状腺手术113例。31例（A组）使用超声刀分离皮下间隙,其中甲状腺腺瘤11例,结节性甲状腺肿20例。82例（B组）使用电凝钩分离皮下间隙,其中甲状腺腺瘤30例,结节性甲状腺肿52例。结果：A组的手术时间为（163.67±67.63）min,长于B组的（114.39±41.76）min,差异有统计学意义（P〈0.05）,A组术后第1天的引流量为（67.33±52.33）ml,平均67ml,B组的引流量为（95.48±86.42）ml,平均95ml。A组和B组术前、术后第1天和术后第3天的C-反应蛋白（CRP）,术后第1天体温比较差异无统计学意义（P〉0.05）。结论：电凝钩用于建立乳晕径路腔镜甲状腺手术的腔隙是安全可行的。

Clinical application of electric coagulation in the endoscopic thyroidectomy by breast approach for thyroid disease

Objective:To explore the feasibility and advantage of endoscopic thyroidectomy by breast approach with electric coagulation.Methods:From Aug.2002 to May.2005,113 patients underwent endoscopic thyroidectomy.The subcutaneous operative space was created with ultrasonic scalpel(31 cases,include 11 adenoma,20 nodular goiter,group A)and electric coagulation(82 cases,include 30 adenoma,52 nodular goiter,group B).Results:The operating time was significantly longer in group A (163.67±67.63)min than that in group B (114.39±41.76)min(P<0.05).The volum of drainage in group A were (67.33±52.33)ml(mean 67ml),group B were (95.48±86.42)ml(mean 95ml).There were no difference about C reaction protein(CRP) at preoperation and 1,3 days after operation(P>0.05).The temperature has no significant difference at 1 day after operation in group A and group B(P>0.05).Conclusions:The electric coagulation is safe to creat the subcutaneous operative space in the endoscopic thyroidectomy by breast approach.