结节性甲状腺肿术后复发原因及防治

目的 分析结节性甲状腺肿术后复发的原因，并探讨防治其术后复发的有效方法。方法 回顾性分析1988～2000年我院收治的结节性甲状腺肿术后复发病人76例。结果 76例中首次手术表现为结节性甲状腺肿58例，甲状腺腺瘤样改变18例。行单纯结节切除16例，腺叶部分切除34例，一侧次全切除加对侧结节摘除18例，双侧腺叶次全切除8例。再次手术均行双侧甲状腺叶次全切除术。术后无严重并发症。再次术后给予甲状腺素片治疗。随访2～10年，无一例复发。结论 结节性甲状腺肿术后复发与病变性质，手术适应证的掌握以及手术方式密切相关。严格掌握手术指征，正确选择手术方式以及术后系统的服用甲状腺素，可以降低结节性甲状腺肿术后复发。

Cause of postoperative recurrence in patients of nodular goiter and its prevention and treatment

Objective To analyse the cause of postoperative recurrence in patients with nodular goiter and its prevention and treatment.Methods 76 cases with nodular goiter from 1998 to 2000 were retrospective analysed.Results Among the 76 cases there were 58 cases with nodular goiter and 18 cases with thyroid adenoma in first operation.26 patients had simple nodular resection,34 patients had partial lobe resection,18 patients had subtotal thyroidectomy puls opposite nodular resection,8 patients had bilateral subtotal thyroidectomies.All patients had bilateral subtotal thyroidectomies in secondary operation.No without serious postoperative complications.Occurred and all patient received thyroxine replacement therapy after secondary operation.76 patients were followed up for 2 to 10 years,nobody had recurrence.Conclusions The recurrence is associated with the pathology,the indication and types of primary surgery.Strictly masted operative indication,properly applied operative mode and routime postoperative thyroxine replacement therapy can help reduce the postoperative recurrence of nodular goiter.