改良颈部切口甲状腺次全切除术治疗双侧结节性甲状腺肿

目的比较改良颈部切口与传统颈部切口行甲状腺次全切除术治疗双侧结节性甲状腺肿的疗效,探讨两种术式的临床应用价值。方法 54例双侧结节性甲状腺肿患者中,25例行改良颈部切口甲状腺次全切除术（观察组）,29例行传统颈部切口甲状腺次全切除术（对照组）。观察两组手术时间、术中出血量、术后止痛剂用量及术后并发症情况。结果两组手术均获成功,术中无输血。两组手术时间与术后住院时间无显著性差异;术中出血量及术后止痛剂用量,观察组少于对照组（均P〈0.01）;两组术后均出现1例声音嘶哑,经治疗后3个月内恢复;48例患者得到3～20个月随访,无并发症及复发。结论与对照组相比,改良颈部切口甲状腺次全切除术治疗双侧结节性甲状腺肿并不增加手术时间,其出血量少、术后止痛剂用量小、切口美观、手术安全、疗效确切。

Modified neck incision subtotal thyroidectomy in the treatment of bilateral nodular thyroid goiter

Objective To compare the curative effect of modified neck incision and traditional neck incision subtotal thyroidectomy in the treatment of bilateral nodular thyroid goiter so as to investigate the clinical application of the two methods.Methods 54 cases with bilateral nodular thyroid goiter were divided into two groups.25 cases were treated with modified neck incision subtotal thyroidectomy while 29 cases with traditional incision subtotal thyroidectomy.Operation time,intraoperative blood loss,postoperative analgesic dosage and complications were observed.Results All operations were successful and no patients were given blood transfusion.The operation time and length of stay of the groups showed no significant difference.The intraoperative blood loss and anodynes dosage of the observation group were less than those of the control group(P < 0.01).There was one patient in each group suffering from hoarseness postoperatively and recovered in 3 months after therapy.No postoperative complications and recurrence occurred during 3 to 20-month-follow-up in 48 cases.Conclusion Compared with traditional neck incision subtotal thyroidectomy,modified neck incision subtotal thyroidectomy does not prolong operation time.It is a safe and effective approach in the treatment of bilateral nodular thyroid goiter with a fine incision,less blood loss and analgesic dosage.