Focus超声刀在甲状腺手术中对甲状旁腺功能的保护作用评价
| 作者: |
1包晓都,
2张筱骅,
1李忠朋,
1王晓荣
1 温州医科大学附属乐清医院 外三科，浙江 乐清 325600 2 温州医科大学附属第一医院 肿瘤外科， 浙江 温州 325000 |
| 通讯: |
张筱骅
Email: cole006@163.com |
| DOI: | 10.3978/.10.3978/j.issn.1005-6947.2015.09.017 |
摘要
目的：探讨甲状腺手术中应用Focus超声刀（UHS）对甲状旁腺（PT）的保护作用。
方法：选择2011年8月—2015年5月接受甲状腺手术的甲状腺肿瘤（TC）患者96例，随机将患者分为观察组和对照组，各48例。观察组采用Focus UHS进行手术；对照组采用传统单极电刀进行手术。比较两组患者相关手术指标和手术前后甲状旁腺激素（PTH）、Ca2+水平以及术后PT损伤情况。
结果：观察组手术时间、切口长度、术中失血量和术后引流量均明显优于对照组（均P<0.05）；两组术前PTH和Ca2+水平无统计学差异（均P>0.05），但术后观察组PTH和Ca2+水平均明显高于对照组（均P<0.05）；观察组术后PT损伤率明显低于对照组（4.2% vs. 16.7%，P<0.05）。
结论：甲状腺手术中应用Focus UHS可以对PT起到明显的保护作用，有利于预防PT功能减退。
关键词：
甲状腺切除术；超声外科手术；甲状旁腺
方法：选择2011年8月—2015年5月接受甲状腺手术的甲状腺肿瘤（TC）患者96例，随机将患者分为观察组和对照组，各48例。观察组采用Focus UHS进行手术；对照组采用传统单极电刀进行手术。比较两组患者相关手术指标和手术前后甲状旁腺激素（PTH）、Ca2+水平以及术后PT损伤情况。
结果：观察组手术时间、切口长度、术中失血量和术后引流量均明显优于对照组（均P<0.05）；两组术前PTH和Ca2+水平无统计学差异（均P>0.05），但术后观察组PTH和Ca2+水平均明显高于对照组（均P<0.05）；观察组术后PT损伤率明显低于对照组（4.2% vs. 16.7%，P<0.05）。
结论：甲状腺手术中应用Focus UHS可以对PT起到明显的保护作用，有利于预防PT功能减退。
Value of using Focus ultrasonic scalpel in parathyroid protection during thyroid surgery
CorrespondingAuthor:ZHANG Xiaohua Email: cole006@163.com
Abstract
Objective: To investigate the effect of use of Focus ultrasonic scalpel on the protection of parathyroid gland (PT) during thyroid surgery.
Methods: Ninety-six patients with thyroid cancer undergoing thyroidectomy from August 2011 to May 2015 were selected, and randomly designated to observational group and control group, with 48 cases in each group. Patients in observational group underwent surgery by using Focus ultrasonic scalpel while those in control group using traditional monopolar electrocautery. The relevant surgical variables, the parathyroid hormone (PTH) and Ca2+ levels before and after surgery as well as the incidence of postoperative PT injury between the two groups of patients were compared.
Results: The surgical variables that included operative time, length of incision, intraoperative blood loss and postoperative drainage volume in observational group were all significantly superior to those in control group (all P<0.05). there was no significant difference in preoperative PTH and Ca2+ levels between the two groups (both P>0.05), but the postoperative PTH and Ca2+ levels were significantly higher in observational group than those in control group (both P<0.05). The incidence of postoperative PT injury in observational group was significantly lower than that in control group (4.2% vs. 16.7%, P<0.05).
Conclusion: Application of Focus ultrasonic scalpel has proven effect on PT protection in thyroid surgery, and is helpful for preventing the occurrence of PT hypofunction.
Keywords：
Methods: Ninety-six patients with thyroid cancer undergoing thyroidectomy from August 2011 to May 2015 were selected, and randomly designated to observational group and control group, with 48 cases in each group. Patients in observational group underwent surgery by using Focus ultrasonic scalpel while those in control group using traditional monopolar electrocautery. The relevant surgical variables, the parathyroid hormone (PTH) and Ca2+ levels before and after surgery as well as the incidence of postoperative PT injury between the two groups of patients were compared.
Results: The surgical variables that included operative time, length of incision, intraoperative blood loss and postoperative drainage volume in observational group were all significantly superior to those in control group (all P<0.05). there was no significant difference in preoperative PTH and Ca2+ levels between the two groups (both P>0.05), but the postoperative PTH and Ca2+ levels were significantly higher in observational group than those in control group (both P<0.05). The incidence of postoperative PT injury in observational group was significantly lower than that in control group (4.2% vs. 16.7%, P<0.05).
Conclusion: Application of Focus ultrasonic scalpel has proven effect on PT protection in thyroid surgery, and is helpful for preventing the occurrence of PT hypofunction.