手术治疗甲状腺结节352例临床分析

目的 总结甲状腺结节的外科治疗经验.方法 回顾性分析手术治疗的352例甲状腺结节患者的临床资料.结果 术后病理提示甲状腺腺瘤182例,结节性甲状腺肿75例,结节性甲状腺肿伴腺瘤形成38例,慢性淋巴细胞性甲状腺炎16例,甲状腺乳头状癌40例,滤泡癌1例.并发单侧喉返神经损伤4例,喉上神经损伤1例,淋巴漏1例,皮下出血2例,皮下气肿1例,伤口感染2例,术后暂时性手足抽搐1例,气管塌陷1例,死亡1例.术后复发9例.结论 应规范甲状腺结节的术前评估,严格甲状腺结节的手术指征.选择合理的手术方式,并提高手术技巧,是减少甲状腺手术并发症和防止术后复发的关键.

Clinical analysis of surgical treament for 352 patients with thyroid nodules

Objective To summarize the experience of surgical treatment for thyroid nodules.Methods The clinical data of 352 patients with thyroid nodules who had received surgical treatment were collected and analyzed retrospectively.Results The post-operation pathological diagnosis showed these cases were composed of 182 thyroid adenomas,75 nodular goiters,38 adenomatous goiters,16 Hashimoto′s diseases,40 papillary carcinomas and 1 follicular carcinoma.Surgical complications included 4 recurrent laryngeal nerve injuries,1 superior laryngeal nerve injury,1 chyle leak,2 neck hematomas,1 pneumoderma,2 wound infections,1 transient hypocalcemia and 1 death from tracheal collapse.9 cases of recurrence were observed.Conclusion Pre-operation evaluation of patients with thyroid nodules should be well performed in order to identify surgical indications.Appropriate surgical procedures and experienced surgical hands may help to reduce operation complications and recurrence rate.