超声刀在分化型甲状腺癌再手术中的应用探讨

丁勇; 吴海涛; 夏存林; 王加亮

doi:10.13898/j.cnki.issn.1000-2200.2017.12.015

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超声刀在分化型甲状腺癌再手术中的应用探讨

丁勇 , 吴海涛 , 夏存林 , 王加亮

文章导航 > 蚌埠医学院学报 > 2017, 42 > 12: (1621-1623)

引用本文:

Citation:

超声刀在分化型甲状腺癌再手术中的应用探讨

江苏省盐城市大丰人民医院(同济大学上海十院医疗集团大丰分院) 普外科, 224100

作者简介: 丁勇(1983-),男,主治医师.

中图分类号: R736.1

Application of harmonic scalpel in the reoperation of differentiated thyroid carcinoma

Department of General Surgery, Dafeng People's Hospital, Yancheng Jiangsu 224100, China
CLC number: R736.1

摘要: 目的：探讨分化型甲状腺癌局部切除术后再次手术中超声刀的应用效果。方法：选取52例分化型甲状腺癌病人，均于病人首次手术时均按良性肿物行局部切除术，术后病理证实为分化型甲状腺癌。所有病人采用随机数字表法分为2组，其中超声刀组（25例）术中全程采用超声刀手术，传统组（27例）术中采用传统结扎方法手术。2组均由同一手术组医生进行操作。分别比较2组手术时间、术中出血量、术后引流量及手术并发症（包括术后出血、喉返神经损伤、甲状旁腺功能减退）。通过规律性随访和复查观察受试者术后半年内的残癌复发率，通过Karnofsky评分评定手术半年后病人的生存质量。结果：超声刀组再次手术时术中出血量、手术时间、术后引流量均小于传统组（P<0.01），术后半年生存质量评分明显优于传统组（P<0.01）；2组术后喉返神经损伤、暂时甲状旁腺功能减退及永久性甲状旁腺功能减退并发症的发生率、甲状腺残癌半年内复发率以及手术费用差异均无统计学意义（P>0.05）。结论：分化型甲状腺癌病人局部切除术后再次手术中应用超声刀要优于传统丝线结扎手术方式，值得推广。
- 甲状腺肿瘤 /
- 超声刀 /
- 再手术
Abstract: Objective:To explore the application effects of the harmonic scalpel in the reoperation of differentiated thyroid carcinoma.Methods:Fifty-two patients with differentiated thyroid carcinoma were treated with local section according to benign masses treatment method,and identified using pathological examination.The patients were randomly divided into the harmonic scalpel group(25 cases treated with harmonic scalpel) and conventional group(27 cases treated with traditional ligation method).All operations were performed by the same doctors.The total operation time,intraoperative bleeding,postoperative drainage and surgical complications(including postoperative bleeding,postoperative recurrent laryngeal nerve paralysis and postoperative hypoparathyroidism) between two groups were compared.The recurrence rate of residual cancer after half a year of operation was observed using the regular follow-up and reexamination,and the quality of life of patients after six months of surgery was assessed using the Karnofsky score.Results:The reoperation time,intraoperative bleeding and postoperative drainage in harmonic scalpel group were less than those in conventional group(P<0.01),and the quality of life in harmonic scalpel group after six months of surgery in harmonic scalpel group was significantly better than that in conventional group(P<0.01).The differences of the postoperative recurrent laryngeal nerve injury,incidence rates of transient and perpetual hypoparathyroidism,recurrence rate of residual cancer after half a year of operation and cost between two groups were not statistically significant(P>0.05).Conclusions:The effect of harmonic scalpel in the reoperation of differentiated thyroid carcinoma is better than that of traditional ligation method,which is worthy of promotion.
- thyroid neoplasms /
- harmonic scalpel /
- reoperation

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超声刀在分化型甲状腺癌再手术中的应用探讨

作者简介: 丁勇(1983-),男,主治医师.

江苏省盐城市大丰人民医院(同济大学上海十院医疗集团大丰分院) 普外科, 224100

收稿日期: 2016-06-30

关键词:

摘要: 目的：探讨分化型甲状腺癌局部切除术后再次手术中超声刀的应用效果。方法：选取52例分化型甲状腺癌病人，均于病人首次手术时均按良性肿物行局部切除术，术后病理证实为分化型甲状腺癌。所有病人采用随机数字表法分为2组，其中超声刀组（25例）术中全程采用超声刀手术，传统组（27例）术中采用传统结扎方法手术。2组均由同一手术组医生进行操作。分别比较2组手术时间、术中出血量、术后引流量及手术并发症（包括术后出血、喉返神经损伤、甲状旁腺功能减退）。通过规律性随访和复查观察受试者术后半年内的残癌复发率，通过Karnofsky评分评定手术半年后病人的生存质量。结果：超声刀组再次手术时术中出血量、手术时间、术后引流量均小于传统组（P<0.01），术后半年生存质量评分明显优于传统组（P<0.01）；2组术后喉返神经损伤、暂时甲状旁腺功能减退及永久性甲状旁腺功能减退并发症的发生率、甲状腺残癌半年内复发率以及手术费用差异均无统计学意义（P>0.05）。结论：分化型甲状腺癌病人局部切除术后再次手术中应用超声刀要优于传统丝线结扎手术方式，值得推广。

English Abstract

Application of harmonic scalpel in the reoperation of differentiated thyroid carcinoma

Department of General Surgery, Dafeng People's Hospital, Yancheng Jiangsu 224100, China

Received Date: 2016-06-30

Abstract: Objective:To explore the application effects of the harmonic scalpel in the reoperation of differentiated thyroid carcinoma.Methods:Fifty-two patients with differentiated thyroid carcinoma were treated with local section according to benign masses treatment method,and identified using pathological examination.The patients were randomly divided into the harmonic scalpel group(25 cases treated with harmonic scalpel) and conventional group(27 cases treated with traditional ligation method).All operations were performed by the same doctors.The total operation time,intraoperative bleeding,postoperative drainage and surgical complications(including postoperative bleeding,postoperative recurrent laryngeal nerve paralysis and postoperative hypoparathyroidism) between two groups were compared.The recurrence rate of residual cancer after half a year of operation was observed using the regular follow-up and reexamination,and the quality of life of patients after six months of surgery was assessed using the Karnofsky score.Results:The reoperation time,intraoperative bleeding and postoperative drainage in harmonic scalpel group were less than those in conventional group(P<0.01),and the quality of life in harmonic scalpel group after six months of surgery in harmonic scalpel group was significantly better than that in conventional group(P<0.01).The differences of the postoperative recurrent laryngeal nerve injury,incidence rates of transient and perpetual hypoparathyroidism,recurrence rate of residual cancer after half a year of operation and cost between two groups were not statistically significant(P>0.05).Conclusions:The effect of harmonic scalpel in the reoperation of differentiated thyroid carcinoma is better than that of traditional ligation method,which is worthy of promotion.