胸骨后甲状腺肿33例的诊断与治疗分析  

Diagnosis and Surgical Treatment of Substernal Goiter: An Analysis of 33 Patients

作　　者：郭榆江[1] 吴政龙[1] 吕夕东 潘瑶[1] 奚忠[1] 

机构地区：[1]南京医科大学附属无锡人民医院,无锡214023

出　　处：《中国现代手术学杂志》2015年第6期418-420,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨胸骨后甲状腺肿的临床表现、诊断和手术治疗方法。方法回顾性分析我院2009年1月至2015年7月所诊治的33例胸骨后甲状腺肿患者的临床资料。结果 33例胸骨后甲状腺肿患者均行手术治疗,31例经颈部低位领形切口完成,2例经颈部低位领形切口加胸骨劈开完成。行全甲状腺切除术19例,单侧甲状腺叶切除术14例(右侧10例,左侧4例)。术后病理:结节性甲状腺肿17例,Grave's病1例,甲状腺腺瘤2例,结节性甲状腺肿伴Grave's病5例,结节性甲状腺肿伴腺瘤6例,甲状腺乳头状癌2例。术后出现喉返神经损伤1例,暂时性低钙血症6例。结论CT是术前检查的最佳手段。绝大多数胸骨后甲状腺肿患者可经颈部低位领形切口完成手术,必要时加行胸骨劈开。Objective To explore the clinical manifestations, diagnosis and surgical treatment of sub- sternal goiter. Methods The clinical data of 33 cases with suhsternal goiter from January 2009 to July 2015 in our hospital were retrospectively analyzed. Results All the 33 cases with substernal goiter were treated by operation. 31 cases were operated by lower collar incision, and 2 cases were operated by lower collar incision plus sternotomy. Total thyroidectomy was performed in 19 cases, and 14 cases underwent unilateral thyroidecto- my（ right 10 cases,left 4 cases）. The pathological results showed nodular goiter in 17 cases, Grave＇s disease in one, thyroid adenoma in 2 cases, nodular goiter with Graves disease in 5 cases, nodular goiter with adenoma in 6 cases, and papillary carcinoma of thyroid in 2 cases. One patient experienced the recurrent laryngeal nerve injury after operation, and six patients experienced transient hypocalcemia after operation. Conclusion CT scanning is valuable in the diagnosis of substernal goiter. Most cases of substernal goiter could be removed suc- cessfully by lower collar incision, but if necessary sternotomy is required.

关 键 词：甲状腺肿 胸骨后 

分 类 号：R653[医药卫生—外科学]