超声刀在甲状腺手术中保护喉返神经及入喉处甲状腺组织的应用效果观察

目的探讨超声刀在甲状腺手术中对于喉返神经及入喉处甲状腺组织的保护作用。方法选取2016年1月至12月间广东省遂溪县人民医院收治的120例甲状腺疾病的患者,随机分为对照组和观察组,每组60例,对照组采用传统电刀手术,观察组采用超声刀进行手术,比较两种手术方式的效果以及对喉返神经及入喉处甲状腺组织的影响。结果相较于传统电刀手术,采用超声刀可明显缩短腺体切除时间和手术总时间,减少术中出血量,差异具有统计学意义(P0.05);两种手术方式在术后引流量和住院时间方面比较,差异无统计学意义(P0.05);观察组患者喉返神经损伤以及甲状旁腺功能低下的发生率低于对照组,但是两组间差异无统计学意义(P0.05),所有观察组患者的声音嘶哑现象均于术后3个月内恢复,而对照组有3例于3~6个月恢复,2例1年以上未好转。结论在甲状腺手术最终采用超声刀可明显缩短手术时间,减少术中出血量,利于术中对喉返神经和入喉处甲状腺组织的辨认和保护,是一种安全可行的手术方法。

Effect Observation of Ultrasound Knife on Recurrent Laryngeal Nerve and Thyroid Tissue Protecting in Thyroid Gland Surgery

Objective To observe the protective effect of ultrasonic scalpel on recurrent laryngeal nerve and thyroid tissue protecting in thyroid gland surgery.Methods 120 patients with thyroid diseases in our hospital from January to December in 2016 were selected and divided into control group and observation group.In control group, patients were operated by traditional electrosurgical scalpel and in observation group patients were operated by ultrasound knife.The effects of the two surgical methods were compared.Results Comparing with electro tome, ultrasound knife can significantly shorten the gland resection time and total operation time, reduce the blood loss during operation, the differences were statistically significant (P<0.05).The differences of postoperative drainage amount and hospital stays were not significant (P>0.05).The incidence of recurrent laryngeal nerve injury and hypoparathyroidism in the observation group was lower than that in the control group, but the difference was not significant (P>0.05).The hoarseness of all the patients in the observation group recovered within 3 months while in the control group 3 cases were in 3~6 months and 2 cases did not recover more than one year.Conclusion Ultrasound knife can significantly shorten the operation time and reduce the amount of blood loss during operation in thyroid surgery, which is helpful for the identification and protection of the recurrent laryngeal nerve and the thyroid tissue.It is a safe and feasible surgical method.