甲状腺全切术治疗甲状腺功能亢进症

Total thyroidectomy for hyperthyroidism

目的探讨甲状腺全切除治疗甲状腺功能亢进症(甲亢)的可行性。方法回顾性分析9年余本院应用甲状腺全切除术治疗3 1例甲亢患者的临床资料,并与同期行传统甲状腺双侧叶次全切除的5 6例患者进行比较。结果甲状腺全切除手术组无术后出血病例,无甲亢复发病例,术后均合并甲减;而甲状腺双侧叶次全切除手术组术后出血率和甲亢复发率分别为3.6%和2 6.8%(两组比较,P值分别为P<0.0 5,P<0.0 1),术后出现甲减2 7(4 8.2%)例。两组术后均无永久性甲状旁腺功能低下并发症,喉返神经损伤发生率无明显差异(P>0.0 5)。结论甲状腺全切除术治疗甲亢效果优于次全切除术,且其并发症总发生率和复发率低于后者。

Objective To discuss the feasibility of total thyroidectomy（TT） for hyperthyroidism.Methods The clinical data of 31 hyperthyroidism patients treated with total thyroidectomy from January 2001 to June 2010 were analyzed retrospectively,and compared with 56 patients treated with subtotal thyroidectomy（ST）.Results There was no postoperative bleeding or recurrence occurred in TT group,but in ST group,postoperative bleeding occurred in 3.6%,and the postoperative recurrence rate was 26.8%,both were was significantly higher than that in TT group（P0.05,P0.01）.On the contrary,only 27 cases（48.2%） suffered from temporary hypothyroidism in ST group,which was significantly less than the TT group in which all cases had hypothroidism.There was no case of permanent hypoparathyroidism in the two groups,and no significant difference in the incidence of recurrent laryngeal nerve between the groups（P0.05）.Conclusions Total thyroidectomy is superior to subtotal thyroidectomy for hyperthyroidism,with the advantages of less recurrence and less postoperative complications.