带状肌分离径路甲状腺腺叶切除术 (pdf)

    [摘要] 目的 探讨因甲状腺肿瘤巨大，经传统中线切口手术难以保全带状肌时的解决方法。方法 对甲状腺肿瘤大于4 cm的病人(74例)，术前随机分为两组：甲组(36例)用传统经中线切口手术方法，乙组(38例)不打开中线，而经带状肌分离径路行甲状腺腺叶切除术。结果 术中需切断带状肌者共16例，甲组15例，乙组1例。术中出血有大于100 ml者9例，甲组8例，乙组1例。喉返神经损伤1例来自甲组。结论 对甲状腺腺瘤大于4 cm的病人，经带状肌分离径路行甲状腺腺叶切除术，较传统经中线切口行甲状腺腺叶切除术方法简便、带状肌切断率低、手术并发症少。

    [关键词] 甲状腺；甲状腺腺叶切除术；手术方式

    Application of separate strap muscles and sternocleidomastoid muscle in hemithyroidectomy

    WU Zhong-xin,SHEN Ping-yun,LU Bao-lin.Department of Surgery,Shanghai Sixth People’s Hospital Jinshan Branch,Shanghai 201500,China

    [Abstract] Objective To study a new clinical method of avoiding mutilation of strap muscles in hemithyroidectomy.Methods 74 patients diagnosed with thyroid adenoma that the diameter of the adenomas were more than 4 centimeter had been studied.These patients were divided stochastically into two groups.Patients in group A(36 cases) had been operated through midline between strap muscles while those in group B (38 cases)had been operated through sideline between strap muscles and sternocleidomastoid muscle.Results Strap muscles of 15 patients in group A(41.66%) and a patient in group B (2.63%)had to be severed during operation.Conclusion Separate strap muscles and sternocleidomastoid muscle in hemithyroidectomy may be a good way to avoiding mutilation of strap muscles in hemithyroidectomy. ......