结节性甲状腺肿术后复发的多因素分析及对策

Multivariate analysis of recurrent predictive factors and strategy of preventing recurrence for nodular goiter after operation

目的探讨结节性甲状腺肿手术后复发的危险因素及减少复发的措施。方法应用单因素分析和Logistic回归多因素分析方法,回顾分析我院367例结节性甲状腺肿手术治疗的临床资料及影响复发的因素。结果平均随访76个月(36～136个月),复发25例,中位复发时间58个月,复发率为6.8%(25/367)。Logistic回归分析结果显示,多发结节,甲状腺切除量和术后是否行甲状腺激素抑制治疗是影响术后复发的危险因素。25例复发患者再手术13例,再手术率为52%(13/25)。结论明确结节性甲状腺肿术后复发的因素,合理选择术式和术后甲状腺激素抑制治疗可有效减少复发。

Objective To identify the predictive factors of postoperative recurrence in patients with nodular thyroid goiter and investigate an appropriate procedure to reduce postoperative recurrence. Method The clinical data of 367 patients were retrospectively analyzed and predictive factors for postoperative recurrence in patients with nodular thyroid goiter were evaluated by univariate and multivariate analysis, Results Recurrence occurred in 25 patients at a median time of 58 months with the incidence of recurrence being 6.8% after mean follow- up time of 76 months （range, 36-136 months）, The multivariate Logistic regression analysis revealed that multiple nodules, resected thyroid weight and postoperative suppressive therapy were independent and statistically significant factors of recurrence. Second operation was performed in 13 patients among 25 postoperative recurrent patients, The reoperative rate in postoperative recurrent patients was 52 % （ 13/25 ）. Conclusion Appropriate operative mode and postoperative suppressive therapy can effectively reduce the postoperative recurrence of nodules goiter.