甲状腺疾病再次手术的原因及并发症分析

目的探讨甲状腺再次手术的原因及手术并发症的预防。方法回顾性分析1990～2001年间甲状腺手术后96例再次手术患者的病例资料。结果甲状腺癌再次手术者31例，占14．0％（31／221），高于总的甲状腺再次手术率的5．3％（96／1805）（P〈0．01）。96例再次手术者发生各种并发症共14例，占14．6％，高于首次手术者的3．7％（63／1709）（P〈0．01）。两次手术为同一侧者51例，手术并发症为11例，占21．6％，高于两次手术为不同侧者的6．7％（3／45）（P〈0．05）；两次手术间隔时间对术后并发症发生率无明显影响（P〉0．05）。结论甲状腺再次手术困难较大，并发症发生率较高。因此首次手术时必须谨慎，应尽可能减少再次手术率。对需要再次手术者，应及时手术。再次手术时应小心细致，减少并发症的发生。

Analysis of the causes and complications of reoperation for thyroid diseases

Objective To study the causes of thyroid reoperation and the prevention of operative (complications). Methods The clinical data of 96 cases who underwent reoperation of thyroid were (retrospctively) analysed. Results There were 31 cases of thyroid carcinoma(14.0%, P<0.05) (undergoing) reoperation, which was higer than that of total thyoid reoperation. There were 14 cases suffered postoperative complications in this series(14.6%), which was higher than for the patients undergoing (primary) operationrate(5.3%)(P<0.05). 11 of 51 patients who underwent two operative interventions on the same side thyroid suffered postoperative complications(21.6%), the rate was higher than for patients in whom both operations involved different sides(6.7%)(P<0.05). The interval between the two (operations) did not affect the rete of (postoperative) complications(P>0.05). Conclusions Thyroid (reoperation) is more difficult than primary operation, and has a higher post-operative complications rate. (Thyroid) reoperation should be avoided or decreased, so the operator should do the best at the time of the (primary) operation, and timely reoperation should be performed when necessary. Thyroid reoperation should be performed carefully to decrease complications as much as possible.