甲状腺再次手术患者并发症分析及对策

Analysis and Countermeasures on Complications for Patients with Reoperation of Thyroid

目的:对甲状腺再次手术患者的并发症情况进行相关分析,提出应对策略。方法:选取我院自2007年5月至2012年3月收治的20例甲状腺手术后再次手术患者作为研究对象,对再次手术发生情况、并发症情况等进行分析。结果:①甲状腺功能亢进、甲状腺肿瘤及结节性甲状腺肿与平均再次手术率比较无明显差异(P>0.05),甲状腺癌再次手术率为14.3%,远高于平均再次手术率(X2=16.258,P<0.01),具有统计学意义。②甲状腺癌发生率为66.7%(4/6),与平均发生率比较甲状腺癌显著增高(X2=13.465,P<0.01),具有统计学意义。③首次与再次甲状腺手术出血发生率比较无明显差异(P>0.05),喉部神经损伤、手足抽搐、甲减、气管软化及甲状腺危象发生率比较均有显著差异(P<0.05,P<0.01),具有统计学意义。结论:甲状腺再次手术并发症发生率较高,尤以甲状腺癌风险最大,因此术中谨慎操作、注意预防术后并发症是改善患者预后的关键措施。

Objective： To analyze the complications for patients with re-operation of thyroid, and proposing the corresponding countermeasures. Method： 20 patients with reoperation of thyroid treated in our hospital from May 2007 to March 2012 were selected as the research objects. The condition of reoperation and complications were analyzed. Results： ①There was no evident difference in comparison of hyperthyroidism, thyroid tumor, thyroid adenoma and average rate of reoperation （ P〉0.05 ）. The average rate of thyroid cancer reoperation was 14.3%, which was higher than average rate of re-operation（ X^2 = 16.258, P〈0.01 ） , which had statistical significance. ②The incidence rate of thyroid cancer was 66.7% （4/6）, which was higher than that of thyroid cancer on average（ X^2 = 13. 465 ,P〈0.01 ） ,which had statistical significance. ③ There was no evident difference in the comparison of incidence rate of thyroid surgery bleeding for the first time and for the second time （ P〉0.05 ）. As for the comparison of incidence rate of laryngeal nerve damage, tetany, hypothyroidism, tracheomalacia and thyrotoxic crisis, the difference was significant（ P〈0.05, P〈O. 01 } ,which had statistical significance. Conclusion： The incidence rate of complications for patients with re -operation of thyroid is higher, especially the risk of thyroid cancer is the greatest, so the key measures to improve the prognosis of patients are to operate carefully and to pay attention to prevent the prognosis after operation.