摘要
目的评估颈侧小切口施行甲状旁腺探查、切除术的临床可行性、安全性及其优势。方法回顾性分析重庆医科大学附属第一医院内分泌乳腺外科2021年4月至11月行颈侧小切口甲状旁腺切除术31例,男11例,女20例,年龄(49.32±13.79)岁,范围为28~86岁,所有患者术前以彩超引导纳米碳注射定位肿大甲状旁腺。记录其手术时间、住院时间、术中出血量、术后引流量及术后并发症等指标,并采用EXCEL 2019软件进行统计分析。结果实施颈侧小切口入路甲状旁腺切除术31例,原发性甲状旁腺功能亢进19例(包括双颈侧小切口切除2例,单侧甲状腺包块切除+肿大甲状旁腺切除术2例,巨大甲状旁腺腺瘤切除1例,单纯局部麻醉下切除1例);继发性甲状旁腺功能亢进行双颈侧小切口甲状旁腺全切+前臂自体甲状旁腺移植12例(包括双侧甲状腺包块切除+双侧甲状旁腺全切+前臂自体甲状旁腺移植2例,局麻+颈丛神经阻滞下切除2例,甲状腺内异位甲状旁腺1例)。其中原发性甲旁亢和继发性甲旁亢的平均手术时间(54.74±27.71、74.14±31.73)min、平均术中出血量(8.11±5.05、14.43±10.94)ml、平均术后引流量(14.37±24.64、26.36±32.87)ml、平均术后甲状旁腺激素(11.59±16.46、26.65±56.38)pg/ml、平均住院时间(10.00±5.09、10.96±4.55)d,术后并发症发生率(3.22%、0%)。结论颈侧小切口甲状旁腺探查或切除术是一种安全有效的手术方式。该术式既可避免对甲状腺组织的刺激和损伤,也可同时完成甲状腺探查术和甲状旁腺探查术。可根据患者基本情况充分评估后选择相应的麻醉方式。
Objective To evaluate the clinical feasibility,safety,and advantages of small lateral cervical incision for parathyroid exploration and resection.Methods A total of 31 consecutive patients who underwent parathyroidectomy with a small lateral cervical incision,in the Department of Endocrinology and Breast Surgery of the First Affiliated Hospital of Chongqing Medical University from Apr.to Nov.2021,including 11 males and 20 females,aged(49.32±13.79)years,ranging from 28 to 86 years,were selected to make retrospective statistical analysis of the surgical time,hospital stay,intraoperative blood loss,postoperative drainage and postoperative complications of the patients.All patients were injected with carbon nanoparticles suspension injection guided by color ultrasound to locate the enlarged parathyroid gland before surgery.EXCEL 2019 software was used for statistical analysis.Results Thirty-one patients underwent parathyroidectomy through a small lateral cervical incision.Primary hyperparathyroidism was performed in 19 cases(including 2 cases with bilateral small lateral cervical incision,2 cases with unilateral excision of thyroid mass combined with parathyroidectomy,1 case with resection of huge parathyroid adenoma,and 1 case with local anesthesia).Twelve patients with secondary hyperparathyroidism underwent total parathyroidectomy through bilateral small lateral cervical incision and forearm autogenous parathyroid transplantation(including bilateral thyroid mass resection combined with bilateral total parathyroidectomy and forearm autogenous parathyroid transplantation in 2 cases,local anesthesia and cervical plexus nerve block in 2 cases,and ectopic parathyroid gland in thyroid in 1 case).Among them,the average operative time of patients with primary hyperparathyroidism was(54.74±27.71&74.14±31.73)min,the average intraoperative blood loss was(8.11±5.05&14.43±10.94)ml,the average postoperative drainage was(14.37±24.64&26.36±32.87)ml,the average postoperative parathyroid hormone was(11.59±16.46&26.65±56.38
作者
宋靖宇
孔令泉
李凡
李云海
肖俊
伍娟
田申
庞华
刘丽萍
李茂萍
彭晓琼
彭钰蓓
马可欣
厉红元
吴凯南
Song Jingyu;Kong Lingquan;Li Fan;Li Yunhai;Xiao Jun;Wu Juan;Tian Shen;Pang Hua;Liu Liping;Li Maoping;Peng Xiaoqiong;Peng Yubei;Ma Kexin;LI Hongyuan;Wu Kainan(Department of Breast and thyroid Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of General Surgery,Sichuan Linshui County People’s Hospital,Guang’an 638500,China;Department of Nuclear Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Ultrasonography,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《中华内分泌外科杂志》
CAS
2022年第4期416-420,共5页
Chinese Journal of Endocrine Surgery
关键词
甲状旁腺功能亢进
局部麻醉
颈侧小切口
甲状旁腺切除术
喉返神经
Hyperparathyroidism
Local anesthesia
A small lateral cervical incision
Parathyroidectomy
Recurrent laryngeal nerve
