良性甲状腺肿瘤手术中甲状旁腺保护的经验分析

目的:探讨良性甲状腺肿瘤手术中甲状旁腺的保护方式,减少术后低血钙的发生率。方法:回顾性分析2006年8月-2012年8月500例良性甲状腺手术的临床资料,随机分传统组和改进组,传统组保留甲状腺后被膜,未寻找甲状旁腺;改进组暴露并保护甲状旁腺,精细被膜解剖,尽量保存甲状旁腺的血供及完整性。术后动态观察监测血清钙变化情况。结果:在术中暴露并保护甲状旁腺组中,术后低钙血症的发生率较未寻找甲状旁腺组患者明显降低,两组比较有统计学意义(P<0.05)。结论:在良性甲状腺肿瘤手术中,采用精细被膜解剖,暴露并原位保护好甲状旁腺及血供,可有效降低甲状旁腺的损伤。

The Experience Analysis of Parathyroid Gland Protection During the Benign Thyroid Neoplasms Surgery

Objective:To explore the protection mode of parathyroid glands during the benign thyroid neoplasms surgery.Methods:Retrospective analysis of clinical data of 500cases of thyroid surgery.From Aug.2006to Aug.2012.Traditional group only preserved posterior capsule,but not presented parathyroid glands during the operation.However,improvement group were performed the liberation and preservation of parathyroid glands and its blood supply during the operation.Postoperative serum calcium level was monitored dynamicly.Results:Postoperative incidence of hypocalcemia in patients exposing and preserving of parathyroid glands during the operation was significantly lower than that in patients with no special preserving of parathyroid glands(P<0.05).Conclusion:During the thyroidectomy procedure,it can effectively decrease the damage of parathyroid to expose and protect the parathyroid in situ by fine membrane anatomy.