关键词: 疼痛, 医用透明质酸钠, 粘连, 腔镜甲状腺手术

Abstract: ［Abstract］ Objective To investigate the preventive effect of Sodium Hyaluronate （HA） on postoperative pain and skin scar adhesion in patients underwent endoscopic thyroidectomy via breast approach. Methods According to patients′ choice， 102 patients with thyroid diseases who needed surgical treatment in our hospital were divided into 4 groups： endoscopic thyroidectomy and using HA group （endoscopic+HA group）， endoscopic group， conventional open surgery and using HA group （open + HA group） and open group. The operation time， the drainage volume in 48 h， VAS pain scores of wounds at 6 h and 24 h postoperatively， and the numbers of analgesics using patients in each group were recorded. Follow up 3 months after surgery， estimated if patients got skin paraesthesia， and skin scar adhesion （degree of light， moderate and severe）. Results Operations of groups were successfully completed. There were no serious complications except each one case of incomplete recurrent laryngeal nerve injury in the Endoscopic + HA group and Open + HA group. According to the comparative analysis， the Endoscopic group took longer time than the Open group. However， the drainage volume in 48 h， VAS pain scores of wounds at 6 h and 24 h postoperatively， and the numbers of analgesics using patients among the groups had no significantly differences. Follow?up 3 months， the numbers of patients with skin paraesthesia among 4 groups had no significant differences. Totally there was no significant difference in the severity of scar adhesions between Endoscopic group and Open group. However， after using HA in both endoscopy group and open group， the cases of moderate and severe skin scar adhesions were decreased obviously， and the differences were statistically significant. Conclusion By using HA， the wound pain won′t be lightened in patients after endoscopic thyroidectomy via breast approach， but it could effectively reduce the occurrence and degree of postoperative skin scar adhesions by following up 3 months.

Key words: sodium hyaluronate, endoscopic thyroidectomy, scar adhesion, pain