西部非洲巨大甲状腺肿的诊治研究  

Discussion on the Diagnosis and Treatment of West African Huge Goiter

作　　者：石尧机 赵杰 叶小武 S.ALHOUDA CHITOU ALLASSANE MAAZOU HALIDOU ISSA ANGO 彭定军[3] 姚立平[3] 吴海峰[3] 肖静[3] 

机构地区：[1]中华人民共和国援非尼日尔医疗队 [2]非洲尼日尔共和国马拉迪医院 [3]北海市人民医院,广西北海536000

出　　处：《中外医学研究》2012年第14期13-16,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨简陋条件下西非巨大甲状腺肿诊断、手术麻醉、解剖方法、手术技巧,减少出血、术后颈部不适和瘢痕。预防和减少喉上神经、喉返神经和甲状旁腺的损伤及术后呼吸困难。方法:回顾性分析2008年11月-2011年11月75例巨大甲状腺肿手术切除患者的临床资料。结果:3年来共治疗巨大甲状腺肿75例,74例治愈,死亡1例。住院5～14d,切口Ⅰ/甲71例,Ⅰ/乙4例,无一例出现术后出血需再手术。抽搐、甲亢危象4例,呼吸困难4例,声嘶4例,呛咳2例。3例发生术后暂时性声嘶,术后1～3个月恢复正常。结论:西非巨大甲状腺肿物采用手术治疗可行。详细询问病史、细致的体格检查及常规的超声检查对巨大甲状腺肿物的性质鉴别仍是简单可行的诊断措施。全麻加气管插管、不断颈前肌群、先摘除瘤体、囊内切除腺体、靠下极结扎甲状腺上动脉、不解剖喉返神经、囊内结扎甲状腺下血管等方法在西非是治疗巨大甲状腺肿较好的方式,具有损伤率低、并发症少、出血少、手术时间短及住院天数少等优点。Objective：To explore the West Africa＇s huge goiter＇s diagnosis,anesthesia,anatomical methods,surgical techniques,to reduce bleeding,postoperative neck discomfort and scarring in the primitive conditions.To prevent and reduce the nerve,laryngeal recurrent laryngeal nerve and parathyroid damage and postoperative difficulty breathing postoperative.Methods：The 75 patients with huge goiters＇s surgical results from November 2008 to November 2011 were analyzed retrospectively.Results：3 years of 75 cases of huge goiters,74 cases were cured,1 death.5-14 days in hospital,the incision I/A in 71 cases,Ⅰ/B in 4 cases,no postoperative bleeding occurred to operation again.Convulsions,hyperthyroidism crises in 4 cases,difficulty breathing in 4 cases,voice hoarse in 4 cases,choke cough in 2 cases.There were 3 cases of postoperative transient hoarseness,and returned to normal after 1 to 3 months.Conclusion：West Africa huge thyroid surgery was feasible.Detailed history,detailed physical examination and routine ultrasound huge thyroid nature of the identification were simple and practical diagnostic measures.Anesthesia and tracheal intubation,continuous anterior muscle,the first removal of the tumor,intracapsular removal of the gland,the lower pole ligation of the superior thyroid artery,anatomy of the recurrent laryngeal nerve,intracystic ligation of thyroid vessels in West Africa were the better way of treating huge goiter.Surgical treatment in West African huge goiter had the damage rate was low,fewer complications and less bleeding,shorter operative time and less hospital days,etc.

关 键 词：巨大甲状腺肿 手术治疗 

分 类 号：R653[医药卫生—外科学]