三种甲状腺手术方式对甲状腺单发结节的治疗效果及对患者甲状腺功能的影响  

Effect of three kinds of thyroid surgery on single thyroid nodule and its influence on thyroid function

作　　者：张凯 张巍巍 ZHANG Kai;ZHANG Wei-wei(Department of General Surgery,Huludao Second People’s Hospital,Huludao 125003,China)

机构地区：[1]葫芦岛市第二人民医院普外肿瘤外科,125003

出　　处：《中国现代药物应用》2021年第21期60-62,共3页Chinese Journal of Modern Drug Application

摘　　要：目的探讨三种甲状腺手术方式在甲状腺单发结节临床治疗中的应用价值。方法60例甲状腺单发结节患者,采用随机综合平衡法分成A组、B组、C组,每组20例。A组采用甲状腺全切术,B组采用甲状腺大部切除术,C组采用甲状腺部分切除术。比较三组患者手术参数、术后并发症发生情况及手术前后甲状腺激素[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]水平。结果B组、C组术中出血量(20.21±2.22)、(20.27±2.14)ml少于A组的(38.42±3.20)ml,住院时间(5.83±0.94)、(6.11±0.81)d短于A组的(8.24±1.01)d,差异具有统计学意义(P<0.05)。术后第1、5天,三组患者FT3水平均低于本组术前,且A组患者显著低于B组、C组,差异具有统计学意义(P<0.05)。B组、C组患者术后并发症发生率分别为5%、0,均低于A组的30%,差异具有统计学意义(P<0.05)。结论在甲状腺单发结节临床治疗中,采用甲状腺大部切除术和甲状腺部分切除术相较于甲状腺全切术,患者有着更快的恢复时间、更好的手术效果,且患者甲状腺功能不会受到严重影响,生活质量显著提高,具有临床推广应用价值。Objective To discuss the practical value of three kinds of thyroid surgery on single thyroid nodule and its influence on thyroid function.Methods A total of 60 patients with single thyroid nodule were divided into group A,group B,and group C by random comprehensive balance method,with 20 cases in each group.Group A underwent total thyroidectomy,group B underwent subtotal thyroidectomy,and group C underwent partial thyroidectomy.The surgical parameters,postoperative complications,and the levels of thyroid hormones[free triiodothyronine(FT3),free thyroxine(FT4),and thyroid-stimulating hormone(TSH)]before and after the operation were compared among the three groups.Results The intraoperative blood loss of group B and group C were(20.21±2.22)and(20.27±2.14)ml,which were less than(38.42±3.20)ml of group A;the hospitalization time of group B and group C were(5.83±0.94)and(6.11±0.81)d,which were shorter than(8.24±1.01)d of group A;all the differences were statistically significant(P<0.05).On the 1st and 5th day after operation,FT3 levels of the three groups were lower than those of this group before operation,and group A was significantly lower than group B and group C.All the differences were statistically significant(P<0.05).The postoperative complication rates in group B and group C were 5%and 0,respectively,which were lower than 30%in group A,and the difference was statistically significant(P<0.05).Conclusion In the clinical treatment of single thyroid nodule,subtotal thyroidectomy and partial thyroidectomy have faster recovery time and better surgical effect,and the patient’s thyroid function will not be affected.It also can improve the quality of life of patients,and it contains the value of clinical promotion and application.

关 键 词：甲状腺部分切除术 甲状腺大部切除术 甲状腺全切术 手术效果 

分 类 号：R653[医药卫生—外科学]