甲状腺全切除和次全切除术对甲状腺癌的治疗效果及安全性的比较  

Efficacy and Safety of Total Thyroidectomy and Subtotal Thyroidectomy for Thyroid Cancer

作　　者：黄华俊[1] 张永康[1] 

机构地区：[1]湖北省襄阳市中心医院,441021

出　　处：《实用癌症杂志》2016年第9期1531-1533,共3页The Practical Journal of Cancer

摘　　要：目的采取甲状腺全切除及次全切除治疗甲状腺癌,分析其治疗效果及安全性。方法对所选的甲状腺癌患者采取甲状腺全切除术及次全切除术,观察对比2组患者的手术情况、术后情况、并发症、治疗效果。结果次全切除组手术时间(33.12±10.10)min、切口长度(3.12±0.21)cm、术后出血量(25.31±4.23)ml、术后住院时间(6.32±1.03)d、术后镇痛时间(12.43±2.91)h,与全切除组比较,均明显减少,差异有统计学意义(P<0.05)。全切除组出现喉返神经损伤5%,呼吸困难10%,声音嘶哑15%,低钙血症15%,并发症总发生率45%,均明显高于次全切除组,差异均有统计学意义(P<0.05)。全切除组的切口满意占40%,次全切除组切口满意占95%,差异有统计学意义(P<0.05)。2组患者术后12 h、24 h疼痛评分、术后复发率无明显差异(P>0.05)。结论甲状腺次全切除术治疗甲状腺癌,能够缩短手术时间,减少术中出血量,减少住院时间及镇痛时间,降低术后并发症发生率,缩小手术切口范围,提高了患者的生活质量,安全有效。Objective To study the efficacy and safety of total thyroidectomy and subtotal thyroidectomy for thyroid cancer. Methods Thyroid cancer patients received total thyroidectomy and subtotal thyroidectomy,operation situation,postopera- tive situation,complication and efficacy of the 2 groups were observed. Results Operation time （33.12 ± 10.10） rain,incision length （3.12 ± 0.21 ） cm, postoperative blood loss （25.31 ± 4.23 ） ml, postoperative length of hospital stay （ 6.32 ± 1.03 ） d, and postoperative analgesia （12.43 ±2.91 ） h of subtotal thyroidectomy group, compared with total thyroidectomy group, de- creased significantly, the difference was statistically significant （ P 〈 0.05 ） ; In the total thyroideetomy group, laryngeal recurrent nerve injury （ 5% ）, breathing difficulties （ 10% ） , voice hoarse （ 15% ） hypocalcemia （ 15% ） , complication rates （ 45% ） were significantly higher than those of subtotal thyroidectomy group,the differences were statistically significant（P 〈 0. 05 ） ;Incision of satisfaction of total thyroidectomy was 40% , and that of subtotal thyroidectomy was 95% , the difference was statistically significant （P 〈 0. 05 ） ;Pain score 12h ,24 h after surgery and postoperative recurrence rate had no obvious difference（ P 〉 0. 05 ）. Conclu- sion Subtotal thyroidectomy for thyroid cancer can shorten the operation time,deerease intraoperative blood loss,shorten hospi- talization time and duration of analgesia, reduce the incidence of postoperative complications, narrow the scope of incision, and in- crease the patientg quality of life,it is safe and effeetive.

关 键 词：甲状腺全切除术 甲状腺次全切除术 甲状腺癌 

分 类 号：R736.1[医药卫生—肿瘤]