甲状腺机能亢进症手术的一种新选择──甲状腺一叶切除和对侧大部切除术

A NEW CHOICE FOR SURGICAL TREATMENT OF HYPERTHYROIDISM——LOBECTOMY AND PARTIAL LOBECTOMY OF OTHER SIDE

目的：探讨甲状腺功能亢进症的手术治疗。方法：１９８３年１月至１９８８年１２月于我院内分泌外科病房接受手术治疗的甲状腺机能亢进症病人６８例，其中３５例接受一直沿用的甲状腺次全切除术，即切除两叶甲状腺大部组织及峡部、锥体叶；另外３３例接受切除一叶、峡部、锥体叶及对侧叶大部组织的手术。结果：前一术式所需平均手术时间为２００ｍｉｎ，后一术式则为１４８ｍｉｎ，两组差别有显著性（Ｐ＜０．００１）。前者有２２例需要输血，平均输血量为３００ｍｌ；而后一手术无一例需要输血，两组差别有显著性（Ｐ＜０．００１）。结论：后一手术方式能显著缩短手术时间及避免输血，且不增加手术合并症。

Objective: To explore the surgical treatment of hyperthyroidism. Methods: 68 patients received thyroidectomy for their hyperthyroidism. 35 cases of them were operated by the conventional subtotal thyroidectomy, in which the greater part of bilateral lobe, isthmus and pyramidal lobe were removed. Other 33 cases were treated with a new procedure, in which one lobe, part of contralateral lobe, isthmus and pyramidal lobe were removed. Results: The average operation time was 200 min in the former group and 148 min in the later group (P<0.001). 63%(22/35) of the former group received blood transfusion (average 300 ml), but none in the latter group (P<0.001). Conclusion: The latter procedure could lessen the operation time and avoid blood transfusion without increasing the surgical complications.