甲状腺全切除术治疗良性甲状腺疾病128例临床疗效

Clinical outcome of total thyroidectomy for management of benign thyroid diseases:a review of 128 cases

目的:探讨甲状腺全切除术治疗甲状腺良性疾病的疗效及术后并发症的预防。方法:回顾性分析128例行甲状腺全切除术的甲状腺良性疾病病人的临床资料,其中首次手术者98例,再次手术者30例。分析总结该128例病人的术后并发症。结果:128例病人术后均未发生永久性甲状旁腺功能低下和永久性喉返神经损伤。首次甲状腺全切除组术后暂时性喉返神经损伤和暂时性甲状旁腺功能低下的发生率均为1.02%,再次手术组的发生率明显增高,分别为10.00%和13.33%,两组比较,Fisher精确概率P分别为0.040、0.011。两组暂时性喉上神经损伤发生率均很低,无明显差别。结论:对符合指征的良性甲状腺疾病,甲状腺全切除术是一合适的治疗选择。熟悉甲状腺解剖和精细手术操作,可有效预防并发症发生。

Objective To investigate the clinical outcome of total thyroidectomy for management of benign thyroid lesions and discuss the prevention of operative complications. Methods The clinical data of 128 cases of benign thyroid lesions treated with total thyroidectomy were analyzed retrospectively and the postoperative complications were discussed. Results No patient developed permanent recurrent laryngeal nerve palsy and permanent hypoparathyroidism in the 98 patients with primary total thyroidectomy; 1 patient （1.02%） developed temporary recurrent laryngeal nerve palsy; and 1 patient （1.02%） developed temporary hypoparathyroidism. In the 30 recurrent patients, the incidence of temporary palsy of the recurrent laryngeal nerve was 10.00%, and the incidence of temporary hypoparathyroidism was 13.33% （Fisher P=O.040 or 0.011, respectively）. The incidence of temporary palsy of the superior laryngeal nerve was low in both groups. Conclusions Total thyroidectomy is an appropriate operation for the management of benign thyroid lesions. Mastering anatomy of the thyroid gland and operating appropriately were the key points to prevent postoperative complications.