“L”形拉钩在腔镜甲状腺功能亢进手术中的应用研究(1)
[摘要] 目的 研究“L”形拉钩在腔镜甲状腺功能亢进手术中的应用价值。 方法 整群抽选2013年7月—2014年8月该院收治的甲状腺功能亢进患者112例，随机法分为观察组(n=56)和对照组(n=56)，观察组行“L”形拉钩腔镜甲状腺大部切除术，对照组采用常规腔镜手术方法切除，术中缝扎腺体进行牵拉。比较两组患者手术时间、术中出血量、住院时间及并发症发生情况。 结果 观察组手术时间(109.8±12.4)min、出血量(106.3±15.7)mL、住院时间(5.3±1.2)d与对照组(138.6±56.2)min、(147.2±50.9)mL、(7.6±2.8)d比较显著较少，差异有统计学意义(P<0.05)；观察组并发症发生率7.1%显著低于对照组26.8%，差异有统计学意义(P<0.05)。 结论 “L”形拉钩应用于腔镜甲状腺功能亢进手术中，操作方便、简单，能显著缩短手术时间、减少出血量，且术后并发症少，安全性高，值得推广。
[关键词] “L”形拉钩；甲状腺功能亢进；腔镜手术
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2016)02(a)-0068-02
Application Analysis of “L” Shape Retractor in the Laparoscopic Hyperthyroidism Surgery
DANG Jian-feng
Minimally invasive surgery， Nanyang Hospital of Traditional Chinese Medicine of Henan Province， 474490 China
[Abstract] Objective To research the application value of "L" shape retractor in the laparoscopic hyperthyroidism surgery. Methods 112 cases of patients with hyperthyroidism treated in our hospital from July 2013 to August 2014 were selected and randomly divided into two groups with 56 cases in each， the observation group were treated with "L" shape retractor laparoscopic subtotal thyroidectomy， the control group were treated with the routine endoscopic surgical resection， the glands were sutured to stretch during operation， the operation time， the intraoperative blood loss， length of stay and the occurrence of complications of the two groups were compared. Results The operation time， the blood loss and the length of stay in the observation group were obviously less than those in the control group (109.8±12.4)min， (106.3±15.7)ml， (5.3±1.2)d vs(138.6±56.2)min， (147.2±50.9)ml， (7.6±2.8)d， the differences were statistically significant(P<0.05)；the incidence of complications in the observation group was obviously lower than that in the control group (7.1% vs 26.8%)， the difference was statistically significant (P<0.05). Conclusion The "L" shape retractor in the laparoscopic hyperthyroidism surgery has an easy and convenient operation， and it can obviously shorten the operation time and reduce the blood loss with few postoperative complications and high security， which is worth promoting.
[Key words] "L" shape retractor； Hyperthyroidism； Laparoscopic surgery
甲状腺功能亢进腔镜手术具有微创、疼痛轻等特点，但手术需要在有限的空间完成，术中易损伤喉返神经、喉上神经，而且传统的缝扎腺体牵拉不能随意调节方向，具有一定的局限性[1-2]。基于此，该研究为探索“L”形拉钩在腔镜甲状腺功能亢进手术中的应用效果，于2013年7月—2014年8月间对该院收治的112例甲亢患者展开了随机对照研究，现报道如下。
1 资料与方法
1.1 一般资料
整群抽选2013年7月—2014年8月该院收治的甲状腺功能亢进患者112例，所有患者经临床诊断及B超等检查确诊，均同意在该院接受甲状腺大部切除术，排除既往有甲状腺手术史者，排除胸骨后甲状腺肿大者，排除心、肝、肾严重疾病者，排除不能耐受手术者，排除不签署知情同意书者。且该研究经该院伦理委员会审核批准。按照随机法将112例患者分为观察组(n=56)和对照组(n=56)，观察组中男19例，女37例，年龄23～62岁，平均(45.7±6.3)岁；病程0.5～9年，平均(4.2±1.7)年；甲状腺肿大Ⅰ°者19例，Ⅱ°者28例，Ⅲ°者9例。对照组中男21例，女35例，年龄21～63岁，平均(46.8±5.9)岁；病程0.5～9年，平均(4.5±1.8)年；甲状腺肿大Ⅰ°者17例，Ⅱ°者31例，Ⅲ°者8例。两组患者基线资料比较差异无统计学意义(P>0.05)，有可比性。 (党建锋)
[关键词] “L”形拉钩；甲状腺功能亢进；腔镜手术
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2016)02(a)-0068-02
Application Analysis of “L” Shape Retractor in the Laparoscopic Hyperthyroidism Surgery
DANG Jian-feng
Minimally invasive surgery， Nanyang Hospital of Traditional Chinese Medicine of Henan Province， 474490 China
[Abstract] Objective To research the application value of "L" shape retractor in the laparoscopic hyperthyroidism surgery. Methods 112 cases of patients with hyperthyroidism treated in our hospital from July 2013 to August 2014 were selected and randomly divided into two groups with 56 cases in each， the observation group were treated with "L" shape retractor laparoscopic subtotal thyroidectomy， the control group were treated with the routine endoscopic surgical resection， the glands were sutured to stretch during operation， the operation time， the intraoperative blood loss， length of stay and the occurrence of complications of the two groups were compared. Results The operation time， the blood loss and the length of stay in the observation group were obviously less than those in the control group (109.8±12.4)min， (106.3±15.7)ml， (5.3±1.2)d vs(138.6±56.2)min， (147.2±50.9)ml， (7.6±2.8)d， the differences were statistically significant(P<0.05)；the incidence of complications in the observation group was obviously lower than that in the control group (7.1% vs 26.8%)， the difference was statistically significant (P<0.05). Conclusion The "L" shape retractor in the laparoscopic hyperthyroidism surgery has an easy and convenient operation， and it can obviously shorten the operation time and reduce the blood loss with few postoperative complications and high security， which is worth promoting.
[Key words] "L" shape retractor； Hyperthyroidism； Laparoscopic surgery
甲状腺功能亢进腔镜手术具有微创、疼痛轻等特点，但手术需要在有限的空间完成，术中易损伤喉返神经、喉上神经，而且传统的缝扎腺体牵拉不能随意调节方向，具有一定的局限性[1-2]。基于此，该研究为探索“L”形拉钩在腔镜甲状腺功能亢进手术中的应用效果，于2013年7月—2014年8月间对该院收治的112例甲亢患者展开了随机对照研究，现报道如下。
1 资料与方法
1.1 一般资料
整群抽选2013年7月—2014年8月该院收治的甲状腺功能亢进患者112例，所有患者经临床诊断及B超等检查确诊，均同意在该院接受甲状腺大部切除术，排除既往有甲状腺手术史者，排除胸骨后甲状腺肿大者，排除心、肝、肾严重疾病者，排除不能耐受手术者，排除不签署知情同意书者。且该研究经该院伦理委员会审核批准。按照随机法将112例患者分为观察组(n=56)和对照组(n=56)，观察组中男19例，女37例，年龄23～62岁，平均(45.7±6.3)岁；病程0.5～9年，平均(4.2±1.7)年；甲状腺肿大Ⅰ°者19例，Ⅱ°者28例，Ⅲ°者9例。对照组中男21例，女35例，年龄21～63岁，平均(46.8±5.9)岁；病程0.5～9年，平均(4.5±1.8)年；甲状腺肿大Ⅰ°者17例，Ⅱ°者31例，Ⅲ°者8例。两组患者基线资料比较差异无统计学意义(P>0.05)，有可比性。 (党建锋)