Graves病的手术前评估与准备(附126例报告)  

Preoperative evaluation and preparation of Graves'disease:a report of 126 cases

作　　者：孙寒星[1] 沈晓卉[1] 高浩基 刘卓然[1] 陈曦[1] 邱伟华[1] 严佶祺[1] SUN Hanxing;SHEN Xiaohui;GAO Haoji;LIU Zhuoran;CHEN Xi;QIU Weihua;YAN Jiqi(Department of Surgery,Ruijin Hospiud,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院外科,上海200025

出　　处：《外科理论与实践》2021年第6期517-521,共5页Journal of Surgery Concepts & Practice

摘　　要：目的:回顾本院Graves病的外科治疗病例,总结术前评估与准备的临床经验.方法:分析2015年1月至2021年5月Graves病126例.收集病例的基础情况、术前准备情况、手术方式、术后病理检查结果和并发症发生资料.结果:病人男27例,女99例,平均年龄(42.4±14.3)岁.手术指征包括Graves病伴恶性肿瘤、气道受压狭窄、胸骨后甲状腺肿、药物治疗不耐受、甲状旁腺功能亢进等.恶性肿瘤中甲状腺乳头状癌75例,其中47例为乳头状微小癌;另2例滤泡状癌.术后近期并发症发生有声音嘶哑11例,其中1例为永久性;术后低血钙35例,其中1例为永久性.结论:Graves病的术前准备要求个体化、精细化.建议评估碘剂准备、气道和神经监测、甲状旁腺功能、喉返神经变异以及恶性结节.Objective To analyze retrospectively preoperative evaluation and preparation in Graves′ disease patients with surgical treatment. Methods A total of 126 cases of Graves′ disease in our department from January 2015 to May2021 were reviewed. Patient information including preoperative preparation, operative mode, postoperative pathological results and complications were collected. Results There were 27 males and 99 females with an average age of(42.4±14.3)years. Surgical indications were Graves′ disease with malignant tumour, airway compression and stenosis, retrosternal goiter, drug intolerance or hyperparathyroidism. There were 75 cases with thyroid papillary carcinoma including 47 cases with papillary microcarcinoma, and 2 cases with follicular carcinoma. Short-term postoperative complications were 11 cases with hoarseness among which 1 case was permanent, and 35 cases with hypocalcemia among which 1 case was permanent. Conclusions It is indicated that preoperative preparation for Graves′ disease requires individualization and refinement, which include iodine preparation, examination of airway condition and neural monitoring, the evaluation of parathyroid function, recurrent laryngeal nerve variation and malignant nodules.

关 键 词：GRAVES病 甲状腺切除 术前准备 术后并发症 

分 类 号：R736.1[医药卫生—肿瘤]