全甲状腺切除术手术指征、要点及并发症防治

Surgical indication , key point and prevention of complication of total thyroidectomy

目的探讨全甲状腺切除术手术指征、要点及并发症防治。方法回顾性分析中南大学湘雅医院2000年3月至2010年3月施行全甲状腺切除术107例病人的临床资料。结果全组病人均接受全甲状腺切除术,其中甲状腺癌71例,巨大结节性甲状腺肿25例,原发性甲状腺功能亢进6例,桥本病5例。术后均恢复顺利,痊愈出院。5例(4.6%)出现术后并发症,其中单侧喉返神经损伤2例,术后24h内出现颈部血肿呼吸困难1例,甲状旁腺功能暂时低下2例,均治愈。结论分化型甲状腺癌是全甲状腺切除的主要手术适应证。术中精细解剖操作是预防全甲状腺切除术后并发症的关键。

Objective To discuss the surgical indication, key point and prevention of complication of total thyroidectomy. Methods A retrospective analysis of the clinical records of 107 patients from March 2000 to March 2010 at Xiangya Hospital, Central South University undergoing total thyroidectomy was analyzed for the treatment for thyroid diseases. Results Total thyroidectomy was performed in 107 patients including 71 cases of thyroid carcinoma, 25 cases of giant nodular goiter, 6 cases of hyperthyroidism, 5 cases of Hashimoto thyroiditis. All patients discharged and postoperative complications incidence was 4.6%. Two patients had one-sided recurrent laryngeal nerve injury and temporary hypoparathyroidism occurred in 2 cases. One case had neck swelling in 24 hours. Conclusion Total thyroidectomy could be indicated as differentiated thyroid carcinoma. Precise operation is important to prevent the postoperative complication.