手术治疗甲状腺功能亢进148例临床分析

Surgical efficacy for hyperthyroidism： an analysis of 148 cases

目的探讨甲状腺次全切除术治疗甲状腺功能亢进症（甲亢）及效果分析，方法甲亢病人148例．抗甲状腺药物（卡比马唑或甲琉眯唑）控制症状后，根据病情用碘剂或加普萘洛尔进行术前准备，2周后进行甲状腺手术．采用次全切除术切除甲状腺的90%～95％，手术当天及术后2天均应用氢化可的松200mg，术后继续服碘剂2周结果病人无手死亡及甲状腺危象发生，一侧喉返神经损伤2例，一侧喉上神经损伤1例．手足抽搐6例，术后甲亢复发5例．治愈率约96．6％。结论术前充分准备及规范的手术操作，能提高手术成功率．减少并发症的发生。

Objective To investigate subtotal thyroidectomy in treating patients with hyperthyroidism and analyze the effects of treatment. Methods After the symptom was controlled by antithyroid drugs（carbimazole or tapazole） in 148 cases, iodine or iodine combined with proprauolol was given pre-operatively according to the patients＇conditions, and then 90% - 95% of the the xolume of thyroid was reseeted. All cases were administered with 200 mg cetacort on the operation day and the first 2 days after the operation, and iodine was administered to each patient for 2 weeks continuously. Results No cases died of the operation and suffered from the thyroid crisis, unilateral recurrent laryngeal nerve and superior laryngeal nerve was injured in 2 and 1 case, respectively, extremity spasm happened in 6 cases, hyperthyroidism recurred in 5 cases. The recovery rate was 96.6%. Conclusions As the result of sufficient preparation, staudardized manipulation, and the improvement of incision and drainage, elevated successful rate and reduced complications have been achieved.