甲状腺功能亢进症术后复发的再手术治疗

目的 探讨甲状腺功能亢进症术后复发的原因，再手术治疗的适应证及手术方法。方法 收集分析31例术后甲亢复发再手术治疗病例。结果 31例经再手术全部治愈，并发症发生率6.5%，与同期甲亢首次手术比较差异无显著性意义。结论 腺体残留过多是甲亢术后复发的主要原因，有选择地再手术是甲亢术后复发较好的治疗方法。术中细致解剖可避免喉神经、甲状旁腺损伤及大出血的发生，腺体切除应当足够，以避免术后再复发。

Reoperation for postoperative recurrence of hyperthyroidism

ObjectiveTo investigate the causes of postoperative recurrence of hyperthyroidism, and the indications for and modality of reoperation. Method Data of 31 reoperative cases with postoperative recurrence of hyperthyroidism were analyzed retrospectively.ResultsAll 31 patients were cured by reoperation. The incidence of complication was 6 5%,which was not significantly different compared with primary operation treatment. Conclusions Not enough amount of resection of the thyoid in the primary surgery caused postoperative recurrence of hyperthyroidism. Secondary operation was the therapy of choice for the treatment of postoperative recurrence. Careful intraoperative dissection helps to avoid injuries of recurrent nerve, and parathyroid and massive bleeding. Enough residual volume of the thyroid gland should be removed to prevent postoperative re-recurrence.