手术治疗甲状腺疾病426例疗效分析

目的 研究接受外科治疗的甲状腺疾病的构成,总结治疗效果.方法 回顾性分析426例甲状腺手术患者的临床资料.结果 外科治疗的甲状腺疾病明显增加,以结节性甲状腺肿(59.9%)、甲状腺癌(16.6%)为主,甲亢手术减少(P＜0.01),桥本病有所增加(P＜0.05);局限于一侧的良性疾病近年以单侧腺叶切除术(21.3%)为主,甲状腺癌的手术方式主要为患侧腺叶、峡部联合对侧次全切除术;全组发生并发症4.0%,其中术后出血0.5%,喉返神经损伤0.7%,喉上神经损伤0.9%,甲状旁腺永久性损伤0.2%,甲状腺功能低下0.9%,甲状腺危象0.2%,死亡0.2%;术后复发率2.2%.结论 根据病变性质、部位、大小及淋巴结转移情况而采取个体化方案,可有效减少并发症的发生.

Analysis of surgical treatment in 426 patients with thyroid diseases

Objective To study the constitutes of thyroid diseases suffered surgical treatment,and sumup the therapeutic effect.Methods The clinical data of 426 patients with thyroid diseases who suffered surgical treatment.Results Thyroid diseases suffered surgical treatment increased significantly.Most diseases of this group were nodu largoiter(59.9%)and thyroid carcinoma(16.6%).Hyperthyroidism treated by operation was decreasing(P＜0.01),but hashimotos thyroiditis was increasing(P＜0.05).The primary operative modes were total thyroid lobectomy(21.3%)if thyroid benign diseases were localized in one lobe of thyroid.The most operative program of thyroid carcinoma was total affected lobectomy plus is thmus and oppositesub total lobectomy.The prophylactic neck dissection was not suggested.The leading an esthetic modes were general anesthesia.The incidence of operative complications was 4.0%,including postoperative hemorrhage 0.5%,injury of recurrent laryngeal nerve 0.7%,injury of superior laryngeal nerve 0.9%,permanent injury of para-thyroid 0.2%,hypothyroidism 0.9%,hyperthyroidism crisis 0.2%and operative mortality 0.2%.The rate of post operative recurrence was 2.2%,which had decreased several years late(P＜0.05).Conclusions The operation modes should be individualized in light of the lesion pathology,location,size and the situation of lymph metastasis.The measures for reducing the incidence of operative complications are effect.