手术治疗甲状腺机能亢进93例临床分析

SURVEY OF SURGICAL TREATMENT OF 93 CASES OF HYPERTHYROIDISM

目的:探讨我院所作甲状腺机能亢进的甲状腺次全切除术病例的经验教训。方法:将本院28年来外科施行的93例甲亢的甲状腺次全切除术病例资料进行回顾性分析。结果:男8例,女85例,发病年龄男15～56岁,平均36岁;女16～70岁,平均34岁。肿块大小为3～20厘米,16厘米以上占77.42%,病理诊断:弥漫性毒性甲状腺肿92例,双侧结节性毒性甲状腺肿1例。基础代谢率27%～73%,平均46.3%。心电图异常50例占53.76%。术后1例并发甲亢危象,1例并发甲低,房室传导阻滞,均痊愈出院。结论:甲亢的甲状腺次全切除术效果可靠,优于药物治疗,并发症少,术前准备要仔细充分,术中操作要细致,严防并发症的发生,特别是甲低、甲亢危象,旁腺和神经损伤的发生。

Objective： To analyze the hyperthyroidism cases treated by subtotal thyroidectomy for experiences and lessons.Methods： 93 patients from 1980 to 2008 in our hospital with hyperthyroidism treated by subtotal thyroidectomy were retrospectively analyzed.Results： 8 males and 85 females,age 1556 years,mean 36 years：men 1556 mean 36 years;women 1670 mean 34 years.Tumor size 320 cm,above 16 cm accounted for 77.42%,basal metabolic rate 27%73%,average 46.3%.ECG abnormalities accounted for 53.76% of 50 cases.All treated by subtotal thyroidectomy.And the pathological diagnosis： 92 cases of diffuse toxic goiter,1 case of bilateral nodular toxic goiter.1 case of thyroid crisis after surgery,1 case of hypothyroidism with atrioventricular block,both were cured.Conclusion：Hyperthyroidism treating with subtotal thyroidectom is more reliable and better than drug treatment and with fewer complications.To prevent complications,especially hypothyroidism,thyroid crisis,parathyroid and nerve damage,careful preoperative preparation and meticulous surgery operation is required.