陈晓翔



甲状腺手术中应用Focus超声刀对甲状旁腺（PT）的保护作用

陈晓翔

【摘要】目的 研究甲状腺手术中应用 Focus超声刀对甲状旁腺（PT）的保护作用。方法 收集我院68例行甲状腺手术患者，抽签随机分为对照组和观察组，各34例。对照组采用传统电刀，观察组采用Focus超声刀，比较两组手术基本指标和甲状旁腺素（PTH）、血钙（Ca2+）变化，观察并发症情况。结果 观察组手术时间、切口长度、术中出血量、住院时间均低于对照组（P＜0.05）；观察组术后3 d PTH、Ca2+分别较对照组高，差异有统计学意义（P＜0.05）；观察组低钙血症、抽搐发生率与对照组比较，差异无统计学意义（P＞0.05）。结论 Focus超声刀在甲状腺手术应用中具有方便、快捷、高效、安全等优点，对PT保护效果理想。

【关键词】甲状腺手术；Focus超声刀；单极电刀；保护作用

Objective To study protection of parathyroid glands （PT）by focus ultrasonic scalpel in thyroid surgery. Methods 68 patients who received thyroid surgery in our hospital were selected，they were divided into the observation group and the control group by random lot methods （each 34 cases）. The control group used traditional electric scalpel while the observation group used focus ultrasonic scalpel，surgeons，basic operation index in the two groups，parathyroid hormone（PTH），serum calcium （Ca2+）changes were compared，and complications were observed. Results Operation time，incision length，intraoperative blood loss and length of stay in the observation group were significantly lower than the control group（P＜ 0.05）. Postoperative 3 d PTH and Ca2+in the observation group were significantly higher than the control group（P＜0.05）. The incidence of hypocalcemia and hyperspasmia in the two groups，the difference was not statistically significant（P＞0.05）. Conclusion Application of focus ultrasonic scalpel in the thyroid surgery has the advantages of convenient，fast，high efficiency and safety，it has a significant effect on PT protection.

【Key words】Thyroid surgery，Focus ultrasonic scalpel，Unipolar electric scalpel，Protection

甲状腺手术是临床较为常见的外科术式，是治疗甲状腺癌、甲亢等甲状腺疾病的有效手段。传统开放性手术在切除甲状腺病变、疗效肯定的同时也存在着甲状旁腺（PT）功能受损、术后感染、出血等并发症［1］，此外甲状腺疾病患者中，青中年女性比例较高，传统单极电刀切除术在颈部行大切口也严重影响患者的外在美观和加重心理负担。因此如何将甲状腺开放切除术做到微创、安全、美观等是临床外科的重要研究方向。Focus超声刀是一种较为新型的手术刀头，在临床应用中取得较好的效果反馈［2］。据此笔者选取我院2014年4月～2015年8月68例行甲状腺手术患者分组研究，重点探讨Focus超声刀在甲状腺手术中的应用价值及对PT的保护效果。……