手术治疗原发性甲状腺功能亢进症腺体残留量的探讨

Study of gland remnants size on operative primary hyperthyroidism

目的探讨影响原发性甲状腺功能亢进症（原发甲亢）术后甲状腺功能（甲功）的相关因素。方法选取80例经术后病理证实的中、重度原发甲亢病人，记录手术前后的临床资料，术后随访1—8年。采用SAS软件对所得数据进行分析。结果年龄、性别、是否用过甲亢药物、甲亢的病程、术前T3、T4、FT3、FT4对术后甲功的影响差异无显著性，且不存在相关关系。甲状腺全量、残留量、残留率与术后甲功呈直线正相关。结论甲状腺全量、残留量是影响术后甲功的重要因素。建议可应用多元回归方程公式，于术前或术中决定原发甲亢手术中甲状腺腺体的残留量。

Objective Investigate the various factors affecting postoperative function of primary hyperthyroidism. Methods 80 patients with moderate and grave primary hyperthyroidism proven postoperatively and pathologically are selected and clinical data is documented. They are follow - up 1 - 8 years. The obtained data is analyzed by means of SAS software. Results Age, sex, whether taking hyperthyroidism medicine, the course of disease and preoperative T3 ,T4, FT3, FT4 all show no obvious effect on postoperative function of thyroid. There is positive linear correlation between total thyroid weight, remnant weight, remnant ratio and postoperative function of thyroid. Conclusion Total thyroid weight and remnant weight are an important factor affecting postoperative function of thyroid. We advocate that multiple regression equation should be used to determine both preoperatively and postoperatively the thyroid remnant weight of primary hyperthyroidism.