中国医学创新目次胸壁分离新方法在经胸乳径路腔镜甲状腺手术中的应用效果(1)
【摘要】 目的：探讨胸壁分离新方法在经胸乳径路腔镜甲状腺手术中应用效果。方法：选取2013年1月-2016年1月本院收治的135例颈前肿物患者作为研究对象，随机分为对照组68例和观察组67例，对照组给予传统胸壁分离方法，观察组给予胸壁分离新方法，比较两组手术一般情况、疼痛程度、伤口引流量及术后并发症。结果：观察组患者术中皮下剥离面积明显少于对照组，差异有统计学意义(P<0.01)，而两组手术时间和术中出血量比较，差异均无统计学意义(P>0.05)；观察组患者术后24 h疼痛程度和伤口引流量均明显优于对照组，差异均有统计学意义(P<0.01)；观察组患者术后皮肤淤斑发生率低于对照组，差异有统计学意义(P<0.05)，而两组一过性声音嘶哑和低钙性抽搐的发生情况比较差异均无统计学意义(P>0.05)。结论：胸壁分离新方法能够减轻术后疼痛，降低并发症发生率，提高手术的效果。
【关键词】 胸乳径路； 胸壁分离； 腔镜甲状腺手术
【Abstract】 Objective：To investigate the application effect of chest wall new separating method in endoscopic thyroid operation.Method：From January 2013 to January 2016，135 cases of anterior cervical tumor were selected as the research objects，they were randomly divided into the control group of 68 cases and the observation group of 67 cases.The control group was given conventional chest wall separation method，while the observation group was given the new chest wall separating method.The general operation conditions，pain degree，wound induced flow and postoperative complications of two groups were compared.Result：Subcutaneous dissection area of the observation group was significantly less than that of the control group，the difference was statistically significant(P<0.01)，but there were no significant differences of two groups in the operation time and the amount of bleeding during operation(P>0.05).The pain degree and wound induced flow of postoperative 24 h in the observation group were significantly better than that of the control group，the differences were statistically significant(P<0.05).The postoperative incidence of skin ecchymosis in the observation group was lower than that of the control group，the difference was statistically significant(P<0.05)，but there were no significant differences of two groups in the transient voice hoarse and hypocalcemic tetany(P>0.05).Conclusion：Chest wall new separating method can relieve postoperative pain，reduce the incidence of complications and improve the operation effect.
【Key words】 Breast path； Chest wall separation； Endoscopic thyroid operation
First-author’s address：The Seventh People’s Hospital of Nanhai District in Foshan City，Foshan 528247，China
doi：10.3969/j.issn.1674-4985.2016.21.014
经胸乳径路腔镜甲状腺手术(Endoscopic thyroid operation)的手术适应证范围广泛，甲状腺暴露清楚，术后瘢痕较小，但其手术时间较长，剥离的创面面积大，因此术后患者的疼痛程度较重，持续时间长[1-3]。为了不影响腔镜甲状腺手术的精确性，又能减少胸壁剥离创面的大小，同时尽量避免对胸壁血管、神经的损伤，本院选取67例颈前肿物患者，采用改进胸壁分离方法对其进行腔镜甲状腺手术治疗，取得了满意的结果，现报道如下。
1 资料与方法
1.1 一般资料 选取2013年1月-2016年1月本院普通外科收治的颈前肿物患者135例，所有患者入院后均经彩超或CT确诊为甲状腺良性占位性病变。采用随机数字表法分为观察组67例和对照组68例。两组患者在性别、年龄及肿块最大直径一般资料比较差异均无统计学意义(P>0.05)，见表1。, 百拇医药(何超雄 吴慕冰 赵海生 彭宝岗)
【关键词】 胸乳径路； 胸壁分离； 腔镜甲状腺手术
【Abstract】 Objective：To investigate the application effect of chest wall new separating method in endoscopic thyroid operation.Method：From January 2013 to January 2016，135 cases of anterior cervical tumor were selected as the research objects，they were randomly divided into the control group of 68 cases and the observation group of 67 cases.The control group was given conventional chest wall separation method，while the observation group was given the new chest wall separating method.The general operation conditions，pain degree，wound induced flow and postoperative complications of two groups were compared.Result：Subcutaneous dissection area of the observation group was significantly less than that of the control group，the difference was statistically significant(P<0.01)，but there were no significant differences of two groups in the operation time and the amount of bleeding during operation(P>0.05).The pain degree and wound induced flow of postoperative 24 h in the observation group were significantly better than that of the control group，the differences were statistically significant(P<0.05).The postoperative incidence of skin ecchymosis in the observation group was lower than that of the control group，the difference was statistically significant(P<0.05)，but there were no significant differences of two groups in the transient voice hoarse and hypocalcemic tetany(P>0.05).Conclusion：Chest wall new separating method can relieve postoperative pain，reduce the incidence of complications and improve the operation effect.
【Key words】 Breast path； Chest wall separation； Endoscopic thyroid operation
First-author’s address：The Seventh People’s Hospital of Nanhai District in Foshan City，Foshan 528247，China
doi：10.3969/j.issn.1674-4985.2016.21.014
经胸乳径路腔镜甲状腺手术(Endoscopic thyroid operation)的手术适应证范围广泛，甲状腺暴露清楚，术后瘢痕较小，但其手术时间较长，剥离的创面面积大，因此术后患者的疼痛程度较重，持续时间长[1-3]。为了不影响腔镜甲状腺手术的精确性，又能减少胸壁剥离创面的大小，同时尽量避免对胸壁血管、神经的损伤，本院选取67例颈前肿物患者，采用改进胸壁分离方法对其进行腔镜甲状腺手术治疗，取得了满意的结果，现报道如下。
1 资料与方法
1.1 一般资料 选取2013年1月-2016年1月本院普通外科收治的颈前肿物患者135例，所有患者入院后均经彩超或CT确诊为甲状腺良性占位性病变。采用随机数字表法分为观察组67例和对照组68例。两组患者在性别、年龄及肿块最大直径一般资料比较差异均无统计学意义(P>0.05)，见表1。, 百拇医药(何超雄 吴慕冰 赵海生 彭宝岗)