非对称性结节性甲状腺肿手术方式的初步探讨  

Thyroidectomy of non-symmetrical multinodular goiters

作　　者：时伟锋[1] 周士福[1] 

机构地区：[1]江南大学附属医院普通外科,江苏无锡214062

出　　处：《中国现代医学杂志》2014年第26期78-81,共4页China Journal of Modern Medicine

摘　　要：目的探讨以单侧临床症状为主的非对称性结节性甲状腺肿的手术方式。方法回顾性分析该院2004年2月-2006年3月非对称性多发结节性甲状腺肿患者87例,其中男性19例,女性68例,分为甲状腺单侧腺叶切除组和一侧腺叶切除加对侧部分/次全切除手术组,分别比较两组手术后相关并发症率、新发甲状腺结节病例数以及两组再手术率。结果两组手术后甲状旁腺和喉返神经损伤率差异无统计学意义,一侧腺叶切除加对侧部分/次全切除手术组平均手术时间长于单侧腺叶切除组[(96.25±35.74)min比(60.00±17.41)min,P<0.01],后组新发甲状腺结节病例数和再手术病例数均显著性高于前组(7比2,P=0.027;4比1,P=0.036)。结论非对称性结节性甲状腺肿手术中采用一侧腺叶切除加对侧部分/次全切除术较单侧腺叶切除术更有利于减少手术后复发,避免再次手术。[Objective] To evaluate the viability of different thyroidectomies of the non-symmetrical muhinodular goiters. [Methods] From February 2004 to March 2006, 87 patients with non-symmetrical muhinodular goiter underwent hemithyroidectomy or hemithyroidectomy plus subtotal/partial thyroidectomy at our institution, of which there were 68 females. Data of complications, patients with recurrent nodular, and re- operation rate were analyzed. [Results] No significant difference was observed between the complications after surgery. The operating time was higher in bilateral thyroidectomy than hemithyroidectomy （96.25 ± 35.74 rain vs 60.00 ± 17.41 min, P 〈0.01）. There were significant differences in the number of patients with recurrent thyroid nodular and reoperation rate between two groups （7 vs 2 P=0.027, 4 vs 1 P=0.036）. [Conclusions] Hemithyroidectomy plus subtotal/partial thyroidectomy seems to be more suitable for the treatment of patients of non-symmetrical goiters, which might decrease the recurrent thyroid disease rate and reoperation rate.

关 键 词：结节性甲状腺肿 手术 

分 类 号：R581.3[医药卫生—内分泌]