超声刀无缝扎技术在开放性甲状腺手术中的应用

目的：探讨超声刀无缝扎技术在开放性甲状腺手术中的应用价值。 方法：回顾性分析2012年10月—2013年6月148例接受甲状腺手术临床资料，其中78例术中采用超声刀无缝扎技术（超声刀组），70例术中采用高频电刀结合传统缝扎止血等技术（传统组）。分别比较两组手术时间、术中出血量及并发症的发生率。 结果：两组患者在手术方式、疾病构成方面差异无统计学意义（P>0.05）；与传统组相同手术方式比较，超声刀组中手术时间、术中出血量明显减少（均P<0.05）。两组患者均无术后出血、术后喉返神经麻痹、永久性甲状旁腺功能低下发生；术后暂时性甲状旁腺功能低下超声刀组1例（1.3%），传统组2例（2.9%），两组术后总并发症发生率差异无统计学意义（P>0.05）。 结论：开放性甲状腺手术中应用超声刀无缝扎技术能缩短手术时间和减少术中出血量，且不增加术后并发症的发生，具有较好的临床应用价值。

Sutureless technique using harmonic scalpel in open thyroid surgery

Objective: To evaluate the application value of sutureless technique using harmonic scalpel in open thyroid surgery. Methods: The clinical data of 148 patients undergoing thyroid surgery form October 2012 to June 2013 were retrospectively analyzed. Of the patients, sutureless technique using harmonic scalpel was applied during surgery in 78 cases (harmonic scalpel group), and high frequency electric knife combined with conventional hemostatic techniques such as suture ligation was performed in another 70 cases (conventional group). The operative time, intraoperative blood loss and the incidence of complications were compared between the two groups. Results: There was no statistical difference in surgical procedure and disease constitution between the two groups (P>0.05). The operative time and intraoperative blood loss were significantly reduced in harmonic scalpel group compared with conventional group in the same surgical type (both P<0.05). No postoperative bleeding, laryngeal recurrent nerve paralysis, or permanent hypoparathyroidism occurred in any of the patients of both groups, transient hypoparathyroidism occurred in one case in harmonic scalpel group and 2 cases in conventional group respectively, and the overall incidence of postoperative complications in the two groups had no statistical difference (P>0.05). Conclusion: Application of sutureless technique with harmonic scalpel in open thyroid surgery can shorten the operative time and reduce intraoperative blood loss, and does not increase the incidence of postoperative complications, so it has a certain value in clinical application.