胸骨后甲状腺肿的诊断和外科治疗

目的探讨胸骨后甲状腺肿的诊断及外科治疗方法。方法回顾性分析2001年1月～2012年6月24例经手术治疗的胸骨后甲状腺肿患者的临床资料。结果全部病例均行CT和甲状腺核素扫显像检查。19例采用颈部低位领式切口,3例经颈部低位领式切口联合部分胸骨劈开,2例开胸。病理显示结节性甲状腺肿18例,甲状腺腺瘤4例,甲状腺癌2例。无围手术期死亡发生。术后并发症包括2例一过性低钙血症和3例甲状腺功能减退。结论 CT和甲状腺核素扫显像是胸骨后甲状腺的重要诊断方法。大多数患者手术可经颈部低领状切口完成,必要时附加胸骨部分切开。

DIAGNOSIS AND SURGICAL TREATMENT OF THE SUBSTERNAL GOITERS

Objective To probe the diagnosis and surgical management for substernal goiter. Methods A retrospective study on 24 substemal thyroid goiter operated from January 2001 to June 2012 was made. Results All the cases were examined by CT and thyroid radionuclide scaning. 19 were operated through low cervical incision, 3 with combined partial upper sternotomy and 2 with thoracotomy. Pathology revealed nodular goiter in 18 cases, thyroid adenoma in 4 and thyroid carcinoma in 2. No perioperative deaths occurred. Postoperative complications included 2 cases of transient hypocalcemia and 3 of hypothyroidism. Conclusion CT and I - 131 thyroid scaning are the most important diagnostic means of substernal goiter. Most substemal goiters can be remove successfully through a low neck and collar- type incision, although partial upper stemotomy is occasionally required.