65例胸骨后甲状腺肿诊治分析  

Diagnosis and Treatment of 65 Cases with Retrosternal Thyroid

作　　者：丁志平[1] 任朝林[1] 练涛峰[1] 

机构地区：[1]惠州市惠康医院普外科,广东惠州516003

出　　处：《医学综述》2009年第18期2869-2870,共2页Medical Recapitulate

摘　　要：目的探讨胸骨后甲状腺肿(RT)的诊断和外科治疗。方法回顾分析1999年10月至2008年6月我院收治的65例RT患者的临床资料。结果气管压迫为常见症状,主要体征为颈部包块,35例Ⅰ°肿大,30例Ⅱ°肿大。吞咽时多数不能扪及甲状腺下极。8例合并甲状腺功能亢进。病理检查提示48例良性病变,17例恶性病变。结论RT为手术绝对适应证,对无症状者也宜早期手术;CT结合胸部X线检查是术前诊断RT的重要手段,外科手术是治疗本病惟一有效的方法,多数患者可采用颈部低位领状切口完成,气管软化者需行预防性气管切开可避免术后呼吸道梗阻。Objective To investigate the clinical diagnosis and surgical treatment of retrosternal thyroid （RT）. Methods Clinical data of 65 cases with RT from October 1999 to June 2008 were restrospectively analyzed. Results Airway compression was the common symptom. The main sign is the cervical mass,35 cases manifested Ⅰ grade of thyromegaly,30 cases with Ⅱ grade of thyromegaly, the majority of the anus perineum of thyroid can not be touched when swallow. 8 cases of hyperthyroidism combined. 8 ca- ses complicating with hyperthyroidism. The pathological type of 48 cases was benign lesion,and of 17 cases was malignant disease. Conclusion RT is an absolute indication of operation. For patients without symptom, it is proper to operate as early as possible. The preoperative diagnoses were established mainly on the basis of chest X ray combined with CT scan. Surgical removal of the tumor is the best choice with satisfactory prognosis. Most substernal goiters can be removed successlly through a cranscervical approach. Prophylatic tracheotomy is helpful to prevent respiratory tract obstruction after operation.

关 键 词：胸骨后甲状腺肿 诊断 治疗 

分 类 号：R581[医药卫生—内分泌]