结节性甲状腺肿248例手术治疗分析

目的 探讨结节性甲状腺肿外科手术的方式.方法 总结结节性甲状腺肿248例的手术及随访情况.结果 单纯性结节摘除术123例,一侧腺体次全切除83例,双侧腺体次全切除32例,一侧腺体结节摘除+对侧腺体次全切除10例,全组患者行二次手术者12例,其中,甲状旁腺损伤1例(暂时性),喉返神经损伤1例(暂时性),伤口血肿3例.全组病例经随访1～8年无复发病例.结论 单侧腺体单发结节或多发(2个以上)孤立结节施行结节摘除术,单侧或双侧多发密集型结节施行甲状腺次全切除术,尽可能保留囊壁残存的腺体,可有效地防止甲状旁腺、喉返神经损伤及甲状腺功能低下.

Realization of surgical treatment in 248 patients with nodular goiter

Objective To study the surgical treatment of nodular goiter.Methods The surgical treatment effects of 248 cases with nodular goiter were reviewed.Results 123 paitients were cut off the merely nodle,83 patients suffered one side subtotal lobectomy,32 patients suffered doublr subtotal lobectomy, 10 patients suffered one side merely nodle plus oppside subtotal lobectomy, and 12 patients received operations twice,including 1 case (temporarily) of permanent injury of parathyroid, 1 case(temporarily) of injury of recurrent laryngeal never,3 cases of postoperative hemorrhage.All patients were followed up from 1 to 8 years,and no relapse was noted after operation.Conclusion One side thyroid gland nodle or nodles should cut off the merely nodle and it is unneceeary to deal with the blood vessel of the thyroid up and down,one side or double side thyroid gland nodles tightly should operated subtotal lobectomy, to ligate the blood vessel of the thyroid down, not to dispose the recuyyent laryngeal nerve,reserving the left over gland in cyst,and to prevent hypothyroidism and recurrent laryngeal nerve.