甲状腺疾病再次手术56例治疗体会

Reoperation for thyroid disease:a review of 56 cases

目的探讨甲状腺再次手术的特点、手术并发症的预防及应对策略。方法采用病例回顾性分析方法收集2011年1月－2013年7月桂林医学院附属医院甲状腺外科56例甲状腺再次手术患者的病例资料。结果所有患者均无术中及住院期间死亡,其中1例出现永久性喉返神经损伤（1.79%）,行气管切开,半年后拔除气管套管。出现暂时性低钙血症11例（19.64%）,无永久性低钙血症病例。再次手术并发症与手术次数及手术间隔时间无明显关系（P〉0.05）。结论甲状腺再次手术在良恶性甲状腺疾病中均能有效实施,因再次手术难度大且并发症高,应尽可能规范初次手术方式及完善术中快速冰冻病理检查,避免再次手术。

Objective To investigate the characteristics of reoperation for thyroid disease,and to evaluate the prevention and coping strategies for surgical complications. Methods A retrospective analysis was used to collect the cases records from 56 patients with thyroid diseases underwent reoperation cared at Thyroid Surgery Department,Affiliated Hospital of Guilin Medical College January 2011~July 2013. Results Of all patients,no death occurred during surgery and hospital course,complications included one permanent recurrent laryngeal nerve injuries（1.79%）,and tracheotomy was performed and removal of the tracheal tube six months later;11temporary hypocalcemia（about 19.64%）,no permanent hypocalcemia.The number of reoperation complications had no significant association with surgical times and surgery interval（P 〉0.05）. Conclusion Reoperation is an effective implement for benign and malignant thyroid diseases.Because of difficult reoperation has high complication rates,the initial surgical procedure should be standardized as much as possible and it is necessary to improve intra-operative frozen section pathological examination for avoiding reoperation.