原发性甲状腺功能亢进症外科治疗的技术改进研究

The improvement on surgical treatment of primary hyperthyroidism

目的利用特殊手术器材和相应的操作技巧，提高原发性甲状腺功能亢进症（甲亢）外科治疗的手术质量。方法借助MPBS系列器材的深部照明设备和彭氏刮吸解剖技术完成504例原发性甲亢的甲状腺次全切除术。结果手术时间（50±20）min，术中出血量（60±30）ml，住院时间（5±1）d。手术切口细小隐蔽，瘢痕平整。术后出现短暂性声音嘶哑和饮水呛咳各2例。未出现围手术期甲亢危象病例。482例随访（5±3）年，1例复发，2例出现轻度甲状腺功能减低。全组无手术死亡病例。结论MPBS器材和彭氏刮吸解剖技术在原发性甲亢外科治疗中的应用安全可靠，具有术中出血少、手术时间短、切口小、副损伤少的临床效果。

Objective To improve the quality of thyroid surgery through the special surgical instruments and operating skill. Method Sub-total thyroidectomy for 504 patients with primary hyperthyroidism were done through MPBS illuminating instruments and dissection, scrape absorption and electric coagulation skills of PMOD. Results Five hundred and four cases of sub-total thyroidectomy were successfully performed. The operation time was （50 ± 20） minutes. The blood loss volume was （60 ± 30） ml. The hospital duration was （5 ± 1 ） days. The incisions were short and the scars were even. There was 1 case recurrence of hyperthyroidism and 2 cases of hypothyroidism after （5 ± 3 ） years follow-up in 482 patients. There were no postoperative complications of hypoparathyroidism and injury of nerve. Conclusion The MPBS and PMOD instruments can be safely applied in thyroid surgery with the advantage of less blood loss, shorter operation time, smaller incision and less side-injuries.