经胸乳入路腔镜下甲状腺切除术治疗原发性甲状腺功能亢进症（附52例分析）

目的 对经胸乳途径腔镜手术治疗甲状腺功能亢进(甲亢)的52例患者的临床效果经验体会进行总结。方法　自2008年10月~2010年9月,对经内科规范治疗2年以上症状控制不明显的52例甲亢患者实施经胸乳途径行腔镜下甲状腺次全切除术，回顾分析其治疗效果及经验体会。结果　腔镜下完成手术47例,中转开放手术5例: 其中3例因术中出血难以控制，2例甲状腺体积太大,因手术操作空间不够而中转。手术平均时间115 min(90~250 min),术中平均出血量35 ml(25~75 ml)，术后2~3 d拔除颈部引流管，术后平均住院5 d(4~6 d)，术后发生一过性声音嘶哑2例,发生胸前皮下淤斑3例,均在术后短期内恢复，无喉上神经、喉返神经及甲状旁腺损伤。46例术后随访12~24个月。术后出现18例甲状腺功能低下, 16例为暂时性甲状腺功能低下，3个月后恢复正常，2例3个月后甲状腺功能仍未恢复正常, ,需每天口服左旋甲状腺素钠维持甲状腺正常功能，无甲亢症状复发病例，所有患者对术后美容效果非常满意。　结论　腔镜下手术治疗原发性甲亢是安全、有效、微创美容的外科治疗新方法。

Endospopic thyroidectomy in the treatment of primary hyperthyroidism via anterior chest and breast approach(Analysis of 52 cases)

Objective To investigate the effect of patients with primary hyperthyroidism treated by endoscopic surgery through anterior chest and breast approach.Methods From October 2008 to September 2010,.52 cases with primary hyperthyroidism underwent endoscopic subtotal thyroidectomy via anterior chest and breast approach after failure in receiving standardized internal medical treatment over two years.Results Endoscopic operations were finished in 47 cases.The other 5 cases were transferred to open operation becau...