双侧结节性甲状腺肿行甲状腺次全切与甲状腺全切的临床比较  

Clinical Comparison of Subtotal Thyroidectomy and Total Thyroidectomy for Bilateral Nodular Goiter

作　　者：单娜 SHAN Na(Department of General Surgery,General Hospital of Northern Theater,Shenyang 110016,China)

机构地区：[1]北部战区总医院和平院区普通肝胆外科,辽宁沈阳110812

出　　处：《中国医药指南》2020年第19期44-46,共3页Guide of China Medicine

摘　　要：目的研究双侧结节性甲状腺肿采用甲状腺全切与甲状腺次全切两种术式在手术安全性、并发症以及治疗效果方面的差异。方法选择2016年10月至2017年11月收治的100位双侧结节性甲状腺肿病患,随机分组后分别采用不同术式展开手术,比较术后并发症总发生率、手术情况以及临床疗效。结果采用甲状腺次全切的观察组在甲状腺功能低下、甲状旁腺损伤、喉返神经受损三方面并发症发生率上仅为8%,对照组达到26%;手术情况方面,观察组术中出血量更低,手术耗时相对较长,但术后可更早出院;临床疗效方面,按照患者甲状腺肿消失有效情况判定,对照组总有效率为98%,观察组达到100%,两组并无明显差异。结论甲状腺全切术与甲状腺次全切术均能够有效治疗双侧结节性甲状腺肿,相对而言虽然次全切操作下手术耗时更长,但出血量更少,患者术后并发症发生率更低,对喉返神经不易损伤,患者术后恢复速度更快,因此更具临床推广价值。Objective To study the difference of operative safety,complications and therapeutic effect between total thyroidectomy and subtotal thyroidectomy for bilateral nodular goiter.Methods 100 patients with bilateral nodular goiter who were admitted from October 2016 to November 2017 were randomly divided into two groups and operated with different surgical methods.The total incidence of complications,surgical conditions and clinical efficacy were compared.Results The incidence of complications in the observation group with subtotal thyroidectomy was only 8%in hypothyroidism,parathyroid gland injury and recurrent laryngeal nerve injury,compared with 26%in the control group.In terms of operation,the bleeding volume in the observation group was lower and the operation time was longer,but the patients could be discharged earlier after operation.In terms of clinical efficacy,the patients were judged according to the effective situation of goiter disappearance.The total effective rate was 98%in the control group and 100%in the observation group.There was no significant difference between the two groups.Conclusion Total thyroidectomy and subtotal thyroidectomy can effectively treat bilateral nodular goiter.Although subtotal thyroidectomy takes longer time,the amount of bleeding is less,the incidence of complications is lower,the recurrent laryngeal nerve is not easily damaged,and the recovery rate is faster,so it has more clinical popularization value.

关 键 词：甲状腺肿 次全切手术 并发症发生率 

分 类 号：R736.1[医药卫生—肿瘤]