甲状腺疾病不同手术方式的术后并发症分析

目的探讨不同甲状腺疾病手术方式的选择及其术后并发症。方法回顾性分析经手术治疗的58例甲状腺疾病住院病例临床资料，患者接受的手术方式有甲状腺单侧叶＋峡部切除术、甲状腺全切术、甲状腺全切＋中央区淋巴结清扫术、甲状腺二（多）次手术、甲状腺癌根治术＋颈侧区淋巴结清扫术，回顾总结患者术后并发症情况。结果患者术后甲状旁腺素（PTH）均下降，甲状腺单侧叶＋峡部切除术时，其下降程度最小；术后钙均下降，甲状腺二二／多次手术或甲状腺癌根治术＋颈侧区淋巴结清扫术后钙下降值最小；相比甲状腺单侧叶＋峡部切除术的患者，甲状腺全切术、甲状腺全切＋中央区淋巴结清扫术后，患者更易出现手术并发症。结论由于不同疾病不同手术方式并发症的发生率不同，在与患者进行术前沟通时要有针对性，同时在手术中注意保护甲状旁腺和喉返神经，提高手术技巧。

Postoperative complications in different surgical methods for thyroid diseases

Objective To investigate the selection of different surgical methods for thyroid diseases and the postoperative complications.Methods A retrospective analysis was made in the clinical data of 58 hospitalized patients with thyroid diseases.The surgical treatments which were performed on them included unilateral lobe plus isthmus resection,total thyroidectomy,total thyroidectomy plus central lymph nodes dissection,thyroid second(multiple)time operation,and radical correction of thyroid carcinoma plus lymph nodes dissection in cervical region.Their postoperative complications were retrospectively summarized.Results The postoperative parathyroid hormone(PTH)of all those patients significantly decreased(P<0.05),the decreasing degree was the smallest after the unilateral lobe plus isthmus resection.The level of postoperative calcium all decreased,and the decline degree was the smallest after thyroid second(multiple)time operation and radical correction of thyroid carcinoma plus lymph nodes dissection in the cervical region.Compared with the patients receiving unilateral lobe plus isthmus resection,postoperative complications occurred more easily in those receiving total thyroidectomy and total thyroidectomy plus central lymph nodes dissection.Conclusion The complication incidence of different diseases is also different after various surgeries.The preoperative communication with the patients is important,and during the operation,protection of epithelial body and recurrent laryngeal nerve should be paid more attention in order to improve the surgical technique.