甲状腺再次手术的临床分析

目的探讨甲状腺再手术的原因、技术要点及并发症的预防措施。方法回顾性分析21例甲状腺再手术的临床资料,其中恶性肿瘤再手术8例,良性肿瘤13例。探讨再手术的原因、手术入路、术后并发症的预防措施。结果暂时性甲状旁腺功能低下发生率2例占9.52%（2/21）,暂时性喉返神经损伤4.76%（1/21）,总的手术并发症为14.29%（3/21）。结论初次手术方式选择与病理因素为甲状腺疾病再次手术的重要原因。甲状腺疾病的再次手术明显增加损伤喉返神经的机会,术中仔细探查且保护好喉返神经为避免其损伤的关键。甲状腺疾病再手术时风险要较初次手术时大,应尽可能减少甚至避免。

Clinical analysis of thyroid reoperation

Objective To investigate the reasons for thyroid reoperation,reoperation of the technical points and the prevention of complications. Methods Retrospective analyze 32 cases of clinical data of thyroid reoperation,including 12 cases of malignant tumors and 20 cases of benign tumors. Explore the reasons of reoperation,surgical approach,and preventive measures of complication. Results The incidence of transient hypoparathyroidism accounted for 2 cases,in which injury rate of permanent parathyroid is taking up 9. 52%,4. 76% injury of temporary recurrent laryngeal nerve,in total of14. 29% of postoperative complications. Conclusion Frozen section helps to raise the accuracy of diagnosis. Secondary thyroidectomy can be avoided by selecting suitable types of operations. Subtotal thyroidectomy of benign nodular thyroid will be good for preventing reccurence. Secondary thyroidectomy should be safe procedure. Because of the high risk of complications reoperations for thyroid gland disease should be done only if the patient cannot be treated in other ways.