应用超声刀经胸骨切迹下低位切口行甲状腺手术的研究

目的探讨应用超声刀经胸骨切迹下方低位切口行甲状腺手术的可行性和美容效果。方法使用经胸骨切迹下方低位切口应用超声刀行甲状腺切除术20例为研究组．传统经颈部切口甲状腺手术20例为对照组，均由同一手术组医生施术。分别比较2组的切口长度、切除甲状腺时间、术中出血量、术后引流量及手术并发症。结果在相同术式中，研究组的切口长度、手术时间、术中出血量和术后引流量均少于对照组（P〈0．001）；2组的总体手术并发症差异无统计学意义（P〉0．05）；研究组所有患者术后均恢复良好，未发现声音嘶哑、饮水呛咳和术后低血钙性抽搐或胸骨前瘢痕组织增生和肿瘤复发，无明显皮瓣粘连、水肿及颈部紧缩感。结论应用超声刀经胸骨切迹下方低位切口安全可行。它可以满足甲状腺手术所需要的切口暴露．不影响手术的效果，手术并发症少，同时更能满足患者美容的要求。

Application of ultrasonic scalpel under sternal notch low incision in the research of thyroid surgery

Objective To investigate the feasibility and cosmetic effect on the use of ultrasonic scalpel under sternal notch low incision for thyroid surgery. Methods From January 2008 to January 2009, 20 cases of thyroidectomy were performed with ultrasonic scalpel under sternal notch low incision as study group and 20 cases of thyroidectomy were performed with traditional incision as control group. The incisional length, operative time, intraoperative bleeding volume, postoperative drainage volume and operative complications were compared between two groups. Results In the same surgical procedure of the incisional length, operative time, intraoperative bleeding volume, postoperative drainage volume, the study group was less than that the control group （P〈0.01）. The operative complications were not significant difference between two groups （P〉0.05）. In the study group,all cases had a good recovery and no hoarseness,cough in drinking water,convulsion of hypocalcemia, pre-sternal cicatricical tissue hyperplasia, tumor recurrence, no obvious skin flap adhesion, local edema and tightening sensation of neck were found after operation. Conclusion Application of ultrasonic scalpel under sternal notch low incision is a safe and feasible method. It possesses satisfactory exposure of thyroid surgery, good operative efficacy, less operative complications and a cosmetic result.