精细化被膜解剖技术在双侧甲状腺手术中的应用价值

摘要

Objective:To investigate the clinical value of the fine membrane dissection in bilateral thyroid surgery. Methods:The clinical data of 62 patients treated with bilateral thyroid surgery from March 2015 to March 2016 were retrospectively analyzed. Thirty-two patients were treated with the fine membrane dissection technique(observation group),and 30 patients were treated with routine surgery(control group). The levels of PTH and blood calcium between two groups were compared before operation,and after 1 day,7 days and 1 month of surgery. Results:The levels of PTH and blood calcium in observation group at postoperative 1 day,7 days and 1 month were significantly higher than those in control group(P<0. 05). Two groups were followed up for 3 months to 1 year,and no tumor recurrence and permanent hypocalcemia were found. Conclusions:During the bilateral thyroid surgery, applying the fine membrane dissecting technique,preserving the parathyroid gland in situ and more than secondary branching vessel derived from thyroid superior and inferior artery can effectively protect the parathyroid function and decrease the postoperative hypocalcemia.%目的:探讨精细化被膜解剖技术在双侧甲状腺手术中的应用价值.方法:回顾性分析2015年3月至2016年3月62例行双侧甲状腺手术患者的临床资料.其中应用精细化被膜解剖技术行双侧甲状腺手术32例(观察组),常规方法手术30例(对照组).比较2组患者术前、术后第1天、第7天及1个月甲状旁腺激素(PTH)及血钙(Ca2+)的水平.结果:观察组术后第1天、第7天及1个月PTH及血Ca2+的水平均明显高于对照组(P<0.05).2组患者随访3个月至1年,均无永久性低钙血症和肿瘤复发.结论:在双侧甲状腺手术中,应用精细化被膜解剖技术,注重甲状旁腺的原位保留和对甲状腺上、下动脉做到2级以上分支血管的保留,能较好地保护甲状旁腺功能,减少术后低钙血症的发生.