头颈部甲状腺手术牵开器的研制
发布时间：2018-07-14 13:10
【摘要】：目的：通过对甲状腺术中软组织机械牵张法建腔的要素化分析,研制一种颈部手术用牵开器。方法：2013年1月至2013年8月,在我院科接受手术的甲状腺肿瘤患者100例。术中通过程序化手术操作步骤,对腺叶切除,锥叶及喉前区、气食管沟区、胸骨上窝区淋巴清扫中机械牵引组织深度及拉钩手柄相对于术中颈部水平面的倾角测量。得出数据作为颈部手术牵开器的设计依据,并提出设计的总体框架。结果：①100例手术患者的观察及测量均顺利完成。②颈部甲状腺手术拉钩的水平运动轨迹,是以甲状腺为中心,拉钩在颈部水平面呈类圆环形轨迹运动③甲状腺手术中腺叶切除机械牵引软组织深度分别为(上极4.13±0.08cm.中极3.55±0.03cm、下极3.55±0.04cm)；中央区颈淋巴清扫中机械牵引软组织深度分别为(锥叶及喉前区3.49±0.07cm、气食管沟区4.21±0.11cm、胸骨上窝区3.34±0.05cm)④甲状腺手术中腺叶切除,拉钩手柄相对于术中颈部水平面的倾角分别为(上极45.33±0.20°、中极21.11±0.84°、下极21.77±1.93°)；中央区颈淋巴清扫中机械牵引软组织,拉钩手柄相对于术中颈部水平面的倾角分别为(锥叶及喉前区73.58±1.80°、气食管沟区23.27±1.45°、胸骨上窝区43.20±0.88°)。结论：①颈部甲状腺常规手术基本操作为机械牵张法建腔。主要是以甲状腺为中心,拉钩在颈部水平面呈类圆环形轨迹运动,同时拉钩手柄与颈部水平面呈不同倾角(0-75°)牵拉颈部软组织形成操作空间。②通过术中机械牵张法建腔的要素化分析,能够设计出一种手术用牵开器,并提出设计的基本架构。以一个椭圆形水平轨道为支撑,通过连接器连接拉钩(钩端长度3-5cm)。总体结构协同运作,维持对软组织的机械牵引,实现手术操作。
[Abstract]:Objective: to develop a retractor for cervical surgery by analyzing the essential factors of soft tissue distraction during thyroid surgery. Methods: from January 2013 to August 2013, 100 patients with thyroid tumor underwent surgery in our hospital. The depth of the mechanical traction tissue and the inclination of the retractor handle relative to the horizontal plane of the neck were measured during the dissection of the gland lobectomy, the conical lobe and the anterior laryngeal area, the pneumoesophageal sulcus area and the suprasternal fossa area. The data can be used as the basis for the design of the retractor for neck surgery, and the overall frame of the design is put forward. Results the observation and measurement of 1 100 cases of operation successfully completed the horizontal movement track of the retractor in the neck thyroid surgery, which was centered on the thyroid gland. The retractor moves in the horizontal plane of the neck like a circular trajectory. 3 the depth of the soft tissue of mechanical traction after resection of the lobectomy was 4.13 卤0.08cm in the upper pole of thyroidectomy. 3. 55 卤0. 03 cm in the middle pole and 3. 55 卤0.04cm in the lower pole. The depth of the soft tissue of mechanical traction was 3. 49 卤0. 07 cm in the central area and 3. 49 卤0. 07 cm in the anterior larynx area, 4. 21 卤0. 11 cm in the gastroesophageal sulcus area and 3. 34 卤0.05cm in the suprasternal fossa area respectively. The inclination of the retractor handle relative to the horizontal plane of the neck was 45.33 卤0.20 掳in the upper pole, 21.11 卤0.84 掳in the middle pole, 21.77 卤1.93 掳in the lower pole. The inclination of the retractor handle relative to the horizontal plane of the neck was 73.58 卤1.80 掳in the conical lobe and anterior larynx, 23.27 卤1.45 掳in the gastroesophageal sulcus and 43.20 卤0.88 掳in the suprasternal fossa. Conclusion the basic procedure of routine operation of neck thyroid gland is mechanical distraction. Mainly centered on the thyroid gland, the retractor moves like a circular trajectory on the horizontal plane of the neck. At the same time, the retractor handle has different inclination angle (0-75 掳) to pull the neck soft tissue formation operation space .2 through the analysis of the elements of the intraoperative mechanical stretch method to build the cavity, a kind of retractor can be designed, and the basic structure of the design can be put forward. Supported by an elliptical horizontal track, the hook is connected by a connector (hook length 3-5cm). The overall structure works together to maintain the mechanical traction of soft tissue and to realize the operation.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R653
本文编号：2121755
[Abstract]:Objective: to develop a retractor for cervical surgery by analyzing the essential factors of soft tissue distraction during thyroid surgery. Methods: from January 2013 to August 2013, 100 patients with thyroid tumor underwent surgery in our hospital. The depth of the mechanical traction tissue and the inclination of the retractor handle relative to the horizontal plane of the neck were measured during the dissection of the gland lobectomy, the conical lobe and the anterior laryngeal area, the pneumoesophageal sulcus area and the suprasternal fossa area. The data can be used as the basis for the design of the retractor for neck surgery, and the overall frame of the design is put forward. Results the observation and measurement of 1 100 cases of operation successfully completed the horizontal movement track of the retractor in the neck thyroid surgery, which was centered on the thyroid gland. The retractor moves in the horizontal plane of the neck like a circular trajectory. 3 the depth of the soft tissue of mechanical traction after resection of the lobectomy was 4.13 卤0.08cm in the upper pole of thyroidectomy. 3. 55 卤0. 03 cm in the middle pole and 3. 55 卤0.04cm in the lower pole. The depth of the soft tissue of mechanical traction was 3. 49 卤0. 07 cm in the central area and 3. 49 卤0. 07 cm in the anterior larynx area, 4. 21 卤0. 11 cm in the gastroesophageal sulcus area and 3. 34 卤0.05cm in the suprasternal fossa area respectively. The inclination of the retractor handle relative to the horizontal plane of the neck was 45.33 卤0.20 掳in the upper pole, 21.11 卤0.84 掳in the middle pole, 21.77 卤1.93 掳in the lower pole. The inclination of the retractor handle relative to the horizontal plane of the neck was 73.58 卤1.80 掳in the conical lobe and anterior larynx, 23.27 卤1.45 掳in the gastroesophageal sulcus and 43.20 卤0.88 掳in the suprasternal fossa. Conclusion the basic procedure of routine operation of neck thyroid gland is mechanical distraction. Mainly centered on the thyroid gland, the retractor moves like a circular trajectory on the horizontal plane of the neck. At the same time, the retractor handle has different inclination angle (0-75 掳) to pull the neck soft tissue formation operation space .2 through the analysis of the elements of the intraoperative mechanical stretch method to build the cavity, a kind of retractor can be designed, and the basic structure of the design can be put forward. Supported by an elliptical horizontal track, the hook is connected by a connector (hook length 3-5cm). The overall structure works together to maintain the mechanical traction of soft tissue and to realize the operation.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R653
【参考文献】
相关期刊论文 前2条
1 王平;;腔镜甲状腺癌根治术的现状与展望[J];外科理论与实践;2011年06期
2 王平;;完全腔镜治疗甲状腺疾病的适应证及手术技巧[J];中国普外基础与临床杂志;2013年09期
，本文编号：2121755
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2121755.html
最近更新
教材专著
