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河北医学  2017, Vol. 23 Issue (12): 1978-1980    DOI: 10.3969/j.issn.1006-6233.2017.12.012
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在甲状腺手术中应用滴水双极电凝镊的体会
陈泳,张浏阳,薛筠兴,李波,柴吉鑫,敖亚洲
承德医学院附属医院, 河北 承德 067000
Experience of Drip Bipolar Coagulation in Thyroid Surgery
CHEN Yong, ZHANG Liuyang, XUE Junxing, et al
The Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000, China
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摘要 目的:研究滴水双极电凝镊在双侧叶甲状腺手术中的体会。方法:在我院行双侧叶甲状腺手术治疗的520例患者分为研究组和对照组,对研究组患者应用滴水双极电凝镊进行手术治疗,对照组患者使用超声刀进行手术治疗,对比两组患者之间在手术持续时间、术中出血量、喉返神经(Recurrent Laryngeal nerve ,RLN)损伤、术后总引流量、术后甲状旁腺激素(Parathyroid hormone,PTH)和血清钙水平。结果:与对照组对比,研究组的手术持续时间、术中出血量无明显差异,P >0.05,但术后总引流量两者之间有显著差异,P<0.05。研究组患者术后暂时性喉返神经麻痹(Temporary Recurrent Laryngeal nerve palsy,TRLNP)和暂时性甲状旁腺功能低下(甲旁减)的发生率分别为4.2%和5.0%,低于对照组的8.4%和9.2%,其差异有统计学差异,P<0.05,所有患者均无永久性喉返神经麻痹(Permanent Recurrent Laryngeal nerve palsy,PRLNP)和甲旁减。结论:在甲状腺手术中应用滴水双极电凝镊是比较可行的、安全的,能够有效降低甲状腺周围重要组织温度,更好的保护RLN和甲状旁腺,缩短留置引流管的时间。
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关键词 甲状腺手术滴水双极电凝镊喉返神经甲状旁腺    
AbstractObjective: To explore the effect of drip bipolar coagulation in thyroid surgery. Method: 520 patients underwent thyroid operation were divided into research group and control group. Patients in the research group were treated by drip bipolar coagulation and patients in the control group were treated by harmonic scalpel in thyroidectomy. The operative time, bleeding, palsy of recurrent laryngeal nerve, total lead flow after operation, postoperative PTH and the blood calcium were compared between the two groups. Result: There was no difference of the operative time and bleeding in the two groups (P >0.05), but the total lead flow after operation were statistical difference (P<0.05). The complications of transient palsy of recurrent laryngeal nerve and transient function insufficiency of parathyroid were more in the control group (8.4% and 9.2%) than in the research group (4.2% and 5.0%) with statistical difference (P<0.05). There were no permanent palsy of recurrent laryngeal nerve and permanent function insufficiency of parathyroid in the two groups. Conclusion: Drip bipolar coagulation for thyroid operation is safe and can effectively reduce the surrounding temperature of the important tissue, and can protect the recurrent laryngeal nerve and parathyroid and shorten the time of drain in the wound.
Key wordsThyroid operation    Drip bipolar coagulation    Recurrent laryngeal nerve    PTH
    
基金资助:承德市科学技术研究与发展计划项目,(编号:201601A026)
引用本文:   
陈泳,张浏阳,薛筠兴,李波,柴吉鑫,敖亚洲. 在甲状腺手术中应用滴水双极电凝镊的体会[J]. 河北医学, 2017, 23(12): 1978-1980.
CHEN Yong, ZHANG Liuyang, XUE Junxing, et al. Experience of Drip Bipolar Coagulation in Thyroid Surgery. HeBei Med, 2017, 23(12): 1978-1980.
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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2017.12.012     或     http://www.hbyxzzs.cn/CN/Y2017/V23/I12/1978
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