胸骨后甲状腺肿的诊断和手术入路选择  

Diagnosis and Surgical Therapy of Substernal Goiter

作　　者：刘善廷[1,2] 李鹏[1,2] 冯露[1,2] 杜伟[1,2] 赵铭[1,2] 

机构地区：[1]郑州大学附属肿瘤医院 [2]河南省肿瘤医院,河南郑州450008

出　　处：《中国医学创新》2013年第21期92-94,共3页Medical Innovation of China

摘　　要：目的:探讨胸骨后甲状腺肿的诊断方法和手术方式。方法:总结2000-2008年本院收治的97例胸骨后甲状腺肿患者,分析其临床表现、检查结果、手术方式、术后并发症和生存时间。结果:胸骨后甲状腺肿的主要表现为颈部肿物、呼吸不畅或呼吸困难、声音嘶哑或发音变化。65例肿瘤位于主动脉弓水平以上,32例肿瘤下界低于主动脉弓水平。颈部入路手术81例,胸骨劈开手术16例。术后并发症主要为喉返神经损伤和暂时性甲状旁腺功能低下。结论:包括CT和MRI影像学检查是胸骨后甲状腺肿的有效检查手段。颈部手术操作简便,并发症少,大部分胸骨后甲状腺肿能通过颈部手术完成,胸骨劈开手术视野好,位置低体积大或者恶性肿瘤应该考虑胸骨劈开手术。Objective： To investigate the clinical characteristics diagnosis and surgical treatment of substemal goiter. Method： The clinical data of 97 csese with substernal goiters were retrospectively analyzed from 2000 to 2008 in our hospital. The clinical manifestations, examination results, operative method, complications and prognosis were analysised. Resut： The main symptoms of substernal goiter were cervical mass, poor breath or dyspnea, speech change or hoarseness. In 65 cases the tumors were located in the aortic arch level above, and 32 cases the tumor lower below the aortic arch level. The cervical approach was performed in 81 cases, sternum-splitting approach was performed in 16 cases. The major postoperative complication was recurrent laryngeal nerve injury and temporary hypoparathyroidism. Conclusion： Imaging examinations including the CT and MRI is the effective method for substernal goiter. The cervical approach is simple and safety, most substernal goiters can be removed by cervical approach. Sternum-splitting could get enough operation field and be fit for the large and lower tumor or the malignant tumor.

关 键 词：胸骨后甲状腺肿 甲状腺肿瘤 诊断 外科手术 

分 类 号：R653[医药卫生—外科学]