32例胸骨后甲状腺肿的诊治经验  

Diagnosis and surgical treatment of substemal goiter in 32 patients

作　　者：陆立[1] 谭振刚[1] 栾晓丹[1] 周良[1] 胡世国[1] 

机构地区：[1]解放军第230医院,丹东118000

出　　处：《丹东医药》2008年第4期1-3,共3页

摘　　要：目的探讨胸骨后甲状腺疾病的临床表现、诊断和手术治疗。方法回顾性分析1999年至2008年1月手术治疗32例胸骨后甲状腺肿的临床资料。结果临床表现主要为无症状颈部肿物20例，颈部肿物伴随憋气6例，伴随甲亢和声音嘶哑各3例。25例为坠人性胸骨后甲状腺肿，7例为胸内甲状腺肿。良性病变28例，恶性或伴随恶性病变4例。29例采用颈前部低领式切口，3例采用颈胸联合切口。行甲状腺大部切除29例，甲状腺癌根治术3例。手术后声音嘶哑恢复正常2例，声音嘶哑无改善1例。一过性手足抽搐6例。结论多数胸骨后甲状腺肿是颈前部病变向下的延续，颈胸部CT检查是最有效的检查手段。多数病人手术可以经颈部低领式切口完成，必要时行颈胸联合切口。Objective To investigate the clinical characteristics, diagnosis and surgical treatment of substemal goiter. Methods Clinical data of 32 cases of subtemal goiter from Jan 1999 to Jan 2008 were retrospectively analyzed. Result The man symptoms of substemal goiter patients were asymptomatic cervical mass 20, airway obstruction 6, hyperthyroidism and hoarseness was 3, respectively. There were 25 cases of diseending subtemal goiter and 7 cases of truly intrathoracic thyroid. Pathology identified benignity in 28, malignancy in 4. 29 cases were operated through low cervical incision, 3 cases with combined cervici-stenotomic approach. Subtotal thyroidectomy was performed in 29cases, 3 case of thyroid cancer received radical resection. Posterative hoarseness disappeared in 2 patients, while it did not improve in the 1 case. Six patients experienced transient hypocalcemia after operation. Conclusion Substemal goiters often result from the descent of a cervical goiter. CT scanning of meck and thorax is valuable in he diagnosis of substemal goiter. Most substemal goiters can be removed through a transcervivcal approach, although combined cervici-stenotomic approach is occasionally required.

关 键 词：甲状腺肿 胸骨后 诊断 甲状腺部分切除术 

分 类 号：R653[医药卫生—外科学] R651.15[医药卫生—临床医学]