甲状腺机能亢进症术后复发的外科治疗

SURGICAL TREATMENT OF POSTOPERATIVE RECURRENCE OF HYPERTHYROIDISM

甲状腺机能亢进症术后复发(复发甲亢),近年来渐趋用手术治疗。我们近10年来手术治疗甲亢365例中有5例是复发甲亢,效果满意,报道如下。临床资料本组5例,男性1例,女性4例。年龄33～40岁。本院术后复发2例,外院3例。术后复发时间3个月～9年。均出现甲亢症状。

Five cases of postoperative recurrence of hyperthyroidism, of which 1 was male and 4 were female in age from 30 to 40 years, were reported in this article. All cases were Ⅱ degree hyperthyroidism and treated by medicine systematically for more than one year but ineffective. One of them had the symptoms of trachea compression. The preoperative preparation including antithyroid medicine, iodine and inderal given were similar to that in hyperthyroidism. Superior thyroid artery and excess thyroid tissues remained in one or two lobes were discovered in all reoperated caes and were the main causes of recurrence in the cases of this group. Endotracheal anesthesia was suitable for reoperation when which the branches of inferior thyroid artery closely near the gland were ligated. Distinguish the normal anatomical position of upper parathyroid gland and reserving a part of the back capsulae of thyroid about 6 gm of thyroid tissues were the effective measures for avoiding the injuries of parathyroid gland and recurrent laryngeal nerves, and recurrence. The complications such as hypoparathyroidism and injury of recurrent laryngeal nerves etc. were not found in all 5 cases. The following studies of which, the longest one was 10 years, no manifestation of recurrence and hypothyroidism was found in all cases.