甲状腺多发良性结节的全切与次全切疗效分析及术后激素评价  

Analysis of total and subtotal thyroidectomy for benign multiple thyroid nodules and postoperative hormonal evaluation

作　　者：祝琴[1] 李远平[1] 张强[1] 张英毅[1] 赵雪云[1] 黄亮[1] Zhu Qin;Li Yuanping;Zhang Qiang;Zhang Yingyi;Zhao Xueyun;Huang Liang(Department of Milky Surgery,the People's Hospital of Leshan City(Sichuan)614000)

机构地区：[1]乐山市人民医院甲乳外科,四川614000

出　　处：《中国社区医师》2018年第26期54-55,57,共3页Chinese Community Doctors

摘　　要：目的:探讨甲状腺多发良性结节全切术与次全切术的治疗效果和术后激素改变情况。方法:收治甲状腺多发良性结节患者368例,随机分为观察组和对照组,各184例。观察组行甲状腺次全切术,对照组行甲状腺全切术。结果:观察组手术时间显著少于对照组(P<0.05)。观察组对甲状旁腺及喉返神经的显露情况均无对照组好(P<0.05)。治疗后,观察组血清游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)均显著高于对照组(P<0.05),观察组促甲状腺激素(TSH)显著低于对照组(P<0.05)。观察组6个月内复发率显著高于对照组(P<0.05)。结论:甲状腺次全切术作为创伤较小又能保证疗效的一种手术方式,是甲状腺多发良性结节患者的不错选择。Objective:To investigate the therapeutic effect and postoperative hormonal changes of total thyroidectomy and subtotal thyroidectomy for multiple benign thyroid nodules.Methods:368 patients with multiple benign thyroid nodules were selected,they were randomly divided into the observation group and the control group with 184 cases in each group.The observation group received subtotal thyroidectomy,while the control group received total thyroidectomy.Results:The operative time of the observation group was significantly less than that of the control group(P<0.05).The exposure of parathyroid glands and recurrent laryngeal nerve of the observation group was not as good as that of the control group(P<0.05).After the treatment,the FT3 and FT4 of the observation group were significantly higher than those of the observation group(P<0.05),and the TSH of the observation group was significantly lower than that of the control group(P<0.05).The recurrence rate of the observation group within 6 months was significantly higher than that of the control group(P<0.05).Conclusion:Subtotal thyroidectomy is a good surgical method with less trauma and can guarantee curative effect.It is a good choice for patients with multiple benign thyroid nodules.

关 键 词：甲状腺多发良性结节 甲状腺全切除术 甲状腺次全切除术 

分 类 号：R653[医药卫生—外科学]