原发性甲状腺功能亢进症722例外科手术治疗体会

目的 探讨甲状腺功能亢进症（甲亢）外科手术治疗的术前准备方法 及术后并发症预防.方法 经手术次全切除甲状腺病理检查确诊的722例原发性甲亢患者,术前准备均给予口服他巴唑、卢戈氏液、谷维素、维生素B1治疗,如心率〉90次/min、心电图无完全性房室传导阻滞者加服心得安控制心率;术后72 h内每日用0.9%氯化钠100 ml＋地塞米松15 mg静脉滴注,连续用3 d,术后不再口服卢戈氏液.结果 722例全部治愈,无一例死亡及甲亢危象发生,无术中、术后大出血.随访5年内,无一例复发.结论 术前口服他巴唑和卢戈氏液及辅以谷维素、维生素B1、心得安做术前准备,术后使用地塞米松能有效预防甲亢术后严重并发症发生.

Experience on surgical treatment of 722 patients with primary hyperthyroidism

Objective To investigate the preoperative preparation method in the operation of hyperthyroidism and the prevention of its complications. Methods Seven hundred and twenty-two patients with primary hyperthyroid- ism which were diagnosed by pathology were orally administered methimazole,lugol＇ s solution and oryzanol, vitamin B1 , for the patients with heart rate greater than 90 beats/min and the ECG without complete atrioventricular block proprano/ol were administered for control of heart rate. The patients were administered intravenously dexamethazone 15 rag/day in the first three days after operation. Results All patients were cured. No hyperthyroidism crisis intraopera- tive and post operative massive hemorrhage were found. No reeeurrence was found during 5 years＇ postoperative fol- low-up. Conclusion Preoperative use of oral methimazol,lugol, s solution oryzanol vitamin B1 , propranolol for preoperative preparation and postoperative use of dexamethasone is effective in the prevention of postoperative complications of hyperthyroidism.