甲亢术中甲状腺残留量测量方法的改进及意义

The modification and significance of measurement of residual size of thyroid during surgical treatment of hyper thyroidism patients

目的探索甲状腺功能亢进病人的手术中甲状腺残留量的确定方法及意义。方法1990年1月～2003年11月,对368例外科治疗甲亢病人的甲状腺残留量及其临床经过进行比较分析,探讨甲状腺残留量与预后的关系。结果甲状腺残留量确定在5g左右,手术后复发占6%,功能低下占13.4%;甲状腺残留量在2g左右,复发占0%,功能低下占73.4%。随着甲状腺残留量的缩小,手术后复发明显减少,但功能低下明显增多,一部分患者必须终生行甲状腺激素替代疗法。结论甲亢病人甲状腺残留量的大小与预后密切相关,并且在一定程度上可以决定术后复发,甲状腺残留量确定在5g左右为目前外科治疗中最合适的残留量。

Objective To explore the connection of remnant tissue weight and prognoses in subtotal thyroideetomy for Graves＇ disease. Methods From 1990.1 to 2003.11, the remnant tissue weight of 268 patients, surgically treated were analyzed and compared with their clinical progress, the relationship between remnant tissue weight and prognoses was explored. Results If remnant tissue weight of thyroid are about 5g, then recurrence would occur to 6% of the patients and hypothyroidism would occur to 13.4% them ; if about 2g, then there no recurrence occur, hypothyroidism occur to 73.4% of them. With the remnant tissue weight becomes smaller and smaller, recurrence markedly reduced, but hypothyroidism often occurs. Conclusion Remnant tissue weight of thyroid is closely associatied with and 5g is fittest remnant tissue weight in subtotal thyroidectomy for Graves＇ disease.