致气管受压狭窄的巨大甲状腺肿围手术期处理  

Treatment of huge goiters inducing trachea stenosis in perioperative period

作　　者：蒋晓[1] 王振乾[1] 黄河[1] 种景贵[1] 王莉琴[2] 翟东[2] 邵堂雷[3] 

机构地区：[1]解放军第八五医院普外科,上海200052 [2]解放军第八五医院普外科麻醉科,上海200052 [3]上海交通大学医学院附属瑞金医院外科,上海200025

出　　处：《外科理论与实践》2015年第1期53-56,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:探讨致气管受压狭窄的巨大甲状腺肿的围手术期处理。方法 :回顾性分析2002年1月至2013年12月41例致气管受压狭窄的巨大甲状腺肿病人临床资料。结果:41例中24例为非困难气道,17例为困难气道,所有病人麻醉诱导插管均成功。41例切除标本称重为(1 711±188)g。14例为结节性甲状腺肿,6例为慢性淋巴细胞性甲状腺炎,19例为慢性淋巴细胞性甲状腺炎伴结节性甲状腺肿,2例为毒性甲状腺肿。41例均无术后永久性声音嘶哑和低钙血症。仅有2例术后呼吸困难行气管切开。结论:对于致气管受压狭窄的巨大甲状腺肿,术前给予充分评估麻醉风险、术中仔细操作、术后注意呼吸道管理,可以避免围手术期风险。Objective To analyze the treatment of huge goiters inducing trachea stenosis during the perioperative period. Methods Forty-one patients with huge goiters inducing trachea stenosis from January 2002 to December 2013 were analyzed retrospectively. Results Twenty-four patients were non-difficult airway and 17 patients difficult airway. The intubation and anesthesia were all successfully. The mean weight of huge goiters of 41 patients was（1 711 ±188） g. There were nodular goiters in 14 cases, chronic lymphocytic thyroiditis in 6 cases, chronic lymphocytic thyroiditis with nodular goiters in 19 cases and toxic goiters in 2 cases by pathologic examination. The permanent hoarseness and hypocalcemia were not found postoperatively in all 41 patients. Only 2 cases had tracheotomy postoperatively because of dyspnea.Conclusions The risk in perioperative period for the huge goiters inducing trachea stenosis could be avoided when preoperative assessment of the airway is sufficient, operation and postoperative attention of airway management careful.

关 键 词：巨大甲状腺肿 气管狭窄 围手术期 

分 类 号：R653[医药卫生—外科学]