胸骨后甲状腺肿的诊断与治疗

目的探讨胸骨后甲状腺肿物的诊断、外科治疗的手术路径。方法回顾性分析1998～2008年手术治疗胸骨后甲状腺肿患者23例的临床资料，19例采用颈部低领式切口，4例采用颈部低领式切口并胸骨正中劈开。结果23例患者手术治疗均获得成功，其中结节性甲状腺肿16例，甲状腺腺瘤5例，甲状腺乳头状癌2例；术后并发症发生率13％（3／23），无1例死亡。结论颈部低位领式切口入路是切除胸骨后甲状腺良性肿瘤的理想入路方式，具有操作简单、损伤小、并发症少等优点；恶性肿瘤手术径路有待进一步探讨。

Diagnosis and treatment of substernal goiter

Objective To explore the diagnosis and surgical therapy of substernal thyroid goiter. Methods The clinical data of 23 cases of substernal thyroid goiter subject to surgical therapy from 1998 to 2008 were reviewed. Nighteen cases underwent operations by cervical collar incision and 4 cases by cervical collar incision plus sternum split. Results All of the patients achieved good results. Among them, there were 16 cases of nodular thyroid goiter, 5 cases of thyroid adenoma and 2 cases of thyroiditis approved by pathology. There was no death and the incidence of postoperative complicationswas. Conclusion Surgical therapy of substernal thyroid goiter through cervical collar incision was feasible. It had the merits of less invasion, simple manipulation and less complications.