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ORANGE EKSTRAKLASA
Dołączył: 26 Paź 2010
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Ostrzeżeń: 0/5 Skąd: England
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Wysłany: Wto 19:22, 22 Mar 2011 |
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Hyperthyroidism improvement of surgical procedures (report of 81 cases)
Under traction, combined with the extremely sharp separation after exposure, respectively, on the three vascular clamp, close off the upper pole artery and vein, the proximal end of double ligation, and then pulling on it and line up to two Eagle; = a tai G ≥ Slap fog ll0 traction loss, respectively, in the vein treatment, and in true and false under the capsule of the thyroid between the artery and vein ligation. Traction sutured again when necessary. Before tracheal ligation in the isthmus, a small straight clamp removal of the gland contralateral gland removed} with the law after the white line on the outside of the neck, chest trowel placed side medial mastoid Taiwan mouth sewn technique. Skin incision suture line with no damage inside the skin suture. 1.5 surgery and complications: 77 am-side routine subtotal glands, glands in 4 cases the side of the isthmus resection and 61 cases in which blood loss f less than lOOml, 20 例 less than 150ml, after 1 transient tetany occurred down. Hoarseness in 1 case, postoperative complication rate was 2.5. 1.6 follow-up: 8l cases were followed up for 70 down, the average time of 6 months, 68 were cured down, accounting for 97.2I recurrence and hypothyroidism in 1 down, 2.8. 2 to discuss the choice of incision 2.1: All the patients were using a small incision oral surgery, oral surgery is the length of ≤ 5cm, more traditional surgical incisions at both ends of the front over the sternocleidomastoid to be small. There are two advantages: ① Dongguan Science requirements: According to international statistics. Hyperthyroidism in patients with male to female ratio of 1:4, and occurs in 20 to 40 years old, using a small incision, less scarring after healing. ,[link widoczny dla zalogowanych], With beautiful effect, so that patients received surgical treatment is easy; ② reduce trauma: a small incision on the skin damage, less blood loss, after a favorable healing, shorten hospital stay. But in practice, the need to stress two points: first, the choice fell ill, swollen glands under the sick I can be a small incision, but I. Patients should be larger than the patients mouth, not only emphasizes the neglect of aesthetic surgery} followed by the security requirements of surgery should be the number of surgical cases, Anatomy and I are familiar with the neck in order to achieve the desired effect, reduce the concurrent operation disease. 2.2 Some improvements in surgical procedures: ① higher separation flap: The surgical separation of the upper flaps over the thyroid cartilage to the level of more traditional operation,[link widoczny dla zalogowanych], .8 cm, so in using a small incision, and continuously from the neck muscles, still a good exposure to the operative field,[link widoczny dla zalogowanych], easy operation GuanlzxIMedicaIJoumal, Febl999, Vo1.2l, No.1 in the observation and operation; ② continuously from the anterior muscle: to to avoid tissue trauma, bleeding volume, the shortcomings of postoperative recovery. not only significantly reduce the amount of intraoperative bleeding. but also helps to functional recovery after neck surgery 7} ③ silk suture pull bow}: traditional operation in the absence of such action, but through the practice of our department, that this method can help surgeons better exposure glands, especially in the higher position on the pole. laryngeal nerve to avoid injury. to improve the safety of operation; ④ be membrane Operation: This fully exposed, and careful separation of the foundation. In the two capsule between the inferior thyroid artery and vein treatment, the recurrent laryngeal nerve injury can be avoided. reduce surgical complications. ⑤ side of the adequate drainage by siphoning wound exudate. can also be set to avoid drainage of the neck in front of mouth and scar adhesions from the summer {} ⑥ no damage joints Kan intradermal suture: Ferret reduce skin irritation. to reduce scar formation,[link widoczny dla zalogowanych], but also the role of a stern appearance. 2.3 Comparison of surgical treatment: surgical treatment reported a cure rate of hyperthyroidism Qin ~ 9% 3%. Comparison rate group of patients, the cure rate was 97.2, higher than the reported level; recurrence rate was 1.5, the incidence of surgical complications was 2.5 well, below the reported level of high limit; and surgery patients significantly reduced the amount of bleeding (75.3 cases of blood loss, less than 100m1). Reduce scarring after surgery, hospitalization was significantly shorter IH. So we believe that in properly selected patients, based on this technique can be extended style. _
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