小儿慢性甲状腺脓肿16例诊治  

The management of chronic thyroid abscess in children： 16 cases

作　　者：龙淼云[1] 黎洪浩[1] 彭新治[1] 罗定远[1] 黄明清[1] 曾献清 

机构地区：[1]中山大学附属孙逸仙纪念医院甲状腺外科,广州510120 [2]广东省五华县人民医院普通外科,514400

出　　处：《中华内分泌外科杂志》2011年第4期240-241,270,共3页Chinese Journal of Endocrine Surgery

基　　金：广东省自然科学基金项目（8451008901000481）;中山大学医科青年教师科研启动基金资助（2007014）

摘　　要：目的探讨小儿慢性甲状腺脓肿合理的治疗方法。方法回顾性分析中山大学附属孙逸仙纪念医院甲状腺外科2007年7月至2010年6月收治的16例小儿慢性甲状腺脓肿的诊治经过。结果16例中男6例，女10例。发病年龄3．2～8．5岁，中位年龄4．6岁。16例彩色多普勒超声可见甲状腺内低回声区或混合回声区，其中左侧11例（68．75％），右侧5例（31．25％）；12例（75％）脓肿已穿破甲状腺影响周围组织，可见甲状腺周围组织的低回声或混合回声区。7例（43．75％）可找到皮下潜行的瘘管；12例行甲状腺部分切除术（75％），4例行一侧甲状腺全切术（25％），并行脓肿清创术。术后均痊愈，未出现声音嘶哑等并发症，随访3个月至5年无1例复发。结论术前行彩色多普勒超声检查甲状腺，术中清除脓肿并切除瘘管，部分或完整切除一侧甲状腺腺体，术后伤口引流并予敏感菌抗生素是诊治小儿慢性甲状腺脓肿的有效方法。Objective To discuss the management of chronic thyroid abscess in children. Methods The diagnosis and management of 16 children with chronic thyroid abscess admitted from Jul. 2007 to Jun. 2010 in Department of Thyroid Surgery of Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively analyzed. All the patients were checked by Doppler ultrasound. Results Of the patients, 6 were males and 10 were females. The time of onset was from 3.2 years to 8.5 years, with 4.6 years as the median. Hypoechoic or mixed echoic lesions in thyroid were seen on Doppler ultrasound scan in all patients. Abscess was found on the left side of thyroid in 11 cases （68.8%）, and on the right side in 5 cases （31.2%）. Abscess in 12 cases （75%） occupied the whole thyroid and began encroaching the adjacent tissues. Hypodermic fistula was found in 7 cases （43.75%）. 12 cases （75%） underwent part resection of thyroid gland, and 4 cases （25%） underwent total resection of thyroid gland and debridement. All patients recovered and no complication like vocal hoarseness occurred. No recurrence happened within the follow-up of 3 months to 5 years. Conclusions The effective diagnosis of chronic thyroid abscess in children is to perform Doppler ultrasound scan of thyroid gland before operation. Abscess and fistula resection, partial or total resection of the affected side of thyroid gland are needed. Wound drainaze and oostooerative antibiotic are also heloful.

关 键 词：小儿 甲状腺脓肿 

分 类 号：R72[医药卫生—儿科]