甲状腺手术两种显露气管前壁方式的临床效果比较研究
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摘要
目的探讨先显露气管前壁行甲状腺手术的临床价值。方法回顾分析方便选取2012年1月—2018年月1月6年间1 264例行甲状腺手术患者的临床资料。按手术方式随机分为两组:观察组先显露气管前壁甲状腺切除术的有653例;对照组后期显露气管前壁的有611例。比较两种手术方式对手术时间、术程出血、及并发症的影响。结果观察组患者手术时间(63±12)min短于对照组(86±15)min(t=30.194,P<0.01)。术中出血量(52±17)m L、术后引流量(33±9)mL,少对照组(126±9)mL、(53±16)mL、和对照组相比差异有统计学意义(t=95.768、27.613、P<0.01);观察组暂时性喉神经损伤27(4.1%)、暂时性低钙血症42(6.4%)、术后出血2(0.31%)、发生率均低于对照组:49(8.0%)、80(13.1%)、3(0.49%),差异有统计学意义(P<0.05)。结论先显露气管前壁患者实施甲状腺手术进行临床诊治,其手术时间短、出血少、损伤低、并发症少,因而是一种有效、安全、理想的临床诊疗方法,值得临床推广。
Objective To investigate the clinical value of thyroid surgery on the anterior wall of the trachea. Methods The clinical data of 1264 patients undergoing thyroid surgery from January 2012 to January 2018 were convenient retrospectively analyzed. They were randomly divided into two groups according to the surgical procedure: 653 cases of anterior tracheal thyroidectomy were observed in the observation group, and 611 cases were found in the anterior wall of the trachea. The effects of the two surgical procedures on the duration of surgery, bleeding during surgery, and complications were compared.Results The operation time of the observation group was(63±12)min shorter than that of the control group(86±15)min(t=30.194, P<0.01. The intraoperative blood loss was(52 ±17)mL, the postoperative drainage volume was(33 ±9)mL, and the control group was(126 ±9)mL and(53 ±16)mL. Compared with the control group, the difference was significant(t =95.768,27.613, P<0.01); temporary laryngeal nerve injury in the observation group 27(4.1%), temporary hypocalcemia 42(6.4%), postoperative bleeding 2(0.31%), the incidence was lower than the control group: 49(8.0%), 80(13.1%), and 3(0.49%), the difference was statistically significant(P<0.05). Conclusion The anterior wall of the trachea is firstly treated with thyroid surgery for clinical diagnosis and treatment. It has short operation time, less bleeding, less damage and less complications. It is an effective, safe and ideal clinical diagnosis and treatment method, which is worthy of clinical promotion.
Objective To investigate the clinical value of thyroid surgery on the anterior wall of the trachea. Methods The clinical data of 1264 patients undergoing thyroid surgery from January 2012 to January 2018 were convenient retrospectively analyzed. They were randomly divided into two groups according to the surgical procedure: 653 cases of anterior tracheal thyroidectomy were observed in the observation group, and 611 cases were found in the anterior wall of the trachea. The effects of the two surgical procedures on the duration of surgery, bleeding during surgery, and complications were compared.Results The operation time of the observation group was(63±12)min shorter than that of the control group(86±15)min(t=30.194, P<0.01. The intraoperative blood loss was(52 ±17)mL, the postoperative drainage volume was(33 ±9)mL, and the control group was(126 ±9)mL and(53 ±16)mL. Compared with the control group, the difference was significant(t =95.768,27.613, P<0.01); temporary laryngeal nerve injury in the observation group 27(4.1%), temporary hypocalcemia 42(6.4%), postoperative bleeding 2(0.31%), the incidence was lower than the control group: 49(8.0%), 80(13.1%), and 3(0.49%), the difference was statistically significant(P<0.05). Conclusion The anterior wall of the trachea is firstly treated with thyroid surgery for clinical diagnosis and treatment. It has short operation time, less bleeding, less damage and less complications. It is an effective, safe and ideal clinical diagnosis and treatment method, which is worthy of clinical promotion.
引文
[1]康维明,吴恋,于健春,等.北京协和医院1986~2012年甲状腺疾病手术患者甲状腺疾病谱回顾性临床资料分析[J].中国医学科学院学报,2013,35(4):386-392.
[2]轩明.甲状腺手术中显露喉返神经的临床效果分析[J].中国医药指南,2015,13(6):172.
[3]黄华.甲状腺手术中甲状旁腺显露及功能保护的手术分析[J].系统医学,2018,3(15):87-88,91.
[4]王平,燕海潮.腔镜下全乳晕入路甲状腺腺叶切除的方法---王氏七步法[J].中国普通外科杂志,2017,26(5):541-546.
[5]高雪松,唐翀,孙永强,等.环甲间隙入路解剖喉返神经在甲状腺手术中的应用[J].临床医药文献电子杂志,2016,3(48):9492,9494.
[6]罗小明.喉返神经显露在甲状腺切除术中的临床意义[J].中国临床新医学,2016,9(8):729-731.
[7]费建平,王欢锋,晋维林.帝视内窥镜引导气管内插管在甲状腺手术中的应用[J].中华普通外科学文献:电子版,2016,10(1):59-64.
[8]李志涛.经胸前壁乳晕径路内镜甲状腺手术的优势及安全性探讨[J].当代医学,2016,22(2):45-46.
[9]姚永庭.显露喉返神经在高风险甲状腺手术中对喉返神经保护作用[J].中国普通外科杂志,2015,24(5):756-759.
[2]轩明.甲状腺手术中显露喉返神经的临床效果分析[J].中国医药指南,2015,13(6):172.
[3]黄华.甲状腺手术中甲状旁腺显露及功能保护的手术分析[J].系统医学,2018,3(15):87-88,91.
[4]王平,燕海潮.腔镜下全乳晕入路甲状腺腺叶切除的方法---王氏七步法[J].中国普通外科杂志,2017,26(5):541-546.
[5]高雪松,唐翀,孙永强,等.环甲间隙入路解剖喉返神经在甲状腺手术中的应用[J].临床医药文献电子杂志,2016,3(48):9492,9494.
[6]罗小明.喉返神经显露在甲状腺切除术中的临床意义[J].中国临床新医学,2016,9(8):729-731.
[7]费建平,王欢锋,晋维林.帝视内窥镜引导气管内插管在甲状腺手术中的应用[J].中华普通外科学文献:电子版,2016,10(1):59-64.
[8]李志涛.经胸前壁乳晕径路内镜甲状腺手术的优势及安全性探讨[J].当代医学,2016,22(2):45-46.
[9]姚永庭.显露喉返神经在高风险甲状腺手术中对喉返神经保护作用[J].中国普通外科杂志,2015,24(5):756-759.