经胸锁乳突肌内侧缘入路与颈白线入路行甲状腺再次手术的临床效果比较

目的：比较经胸锁乳突肌内侧缘入路与颈白线正中入路行甲状腺再次手术中的临床效果。方法124例甲状腺再次手术患者按随机数字表法分为观察组和对照组，每组62例，观察组采用胸锁乳突肌内侧缘入路的手术方式，对照组采用颈白线正中入路的手术方式，分析两组手术方式对患者治疗效果及术后并发症的影响。结果一侧次全切、双侧次全切、一侧全切、双侧全切、一侧次全切＋一侧全切五种手术方式在两组患者中都有实施，两组手术方式构成情况差异无统计学意义（χ2＝0．784，P＞0．05）；观察组手术总时间、显露甲状腺时间、术中出血量、住院时间均优于对照组（t＝13．357、4．489、18．364、7．294，均P＜0．01）。结论在甲状腺患者行再次手术时采用经胸锁乳突肌可以获得更为清晰的解剖层次，有利于减少手术损伤，对提高患者的救治效果具有重要的意义。

Comparison of the clinical effect of sternocleidomastoid muscle medial border entry and neck line approach in thyroid reoperation

Objective To compare the clinical effect of sternocleidomastoid muscle medial border entry and neck line approach in thyroid reoperation .Methods 124 patients with thyroid reoperation were randomly divided into two groups ,62 cases in each group .The observation group used sternocleidomastoid muscle medial border entry , the control group received neck line approach .The surgical approach and the impact of postoperative complications of the two groups were analyzed .Results Side subtotal bilateral subtotal ,full cut side ,bilateral full cut ,side subtotal＋side full cut five kinds of surgical methods were implemented in the two groups ,the surgery way of both groups had no sig-nificant difference（χ2 =0.784,P〉0.05）.In the observation group,the total time of surgery and revealed thyroid , blood loss,hospital stay were better than those of the control group （t=13.357,4.489,18.364,7.294,all P〈0.01）. Conclusion In patients with thyroid reoperation using sternocleidomastoid can get a clearer anatomical level ,which helps to reduce surgical trauma ,improve the patients＇treatment effect .