手术治疗难治性甲状腺功能亢进症56例疗效分析  

Clinical efficacy of surgical treatment of refractory hyperthyroidism in 56 patients

作　　者：李莉红 蒋忠军[1] 包铮[1] 胡聂[1] 易念[1] 王莉[1] 徐舸 Li Lihong;Jiang Zhongjun;Bao Zheng;Hu Nie;Yi Nian;Wang Li;Xu Ge(Department of Breast and Thyroid Surgery,Affiliated Nanhua Hospital of University of South China,Hengyang 421200,Hunan Province,China)

机构地区：[1]南华大学附属南华医院乳甲外科,衡阳421200

出　　处：《中国基层医药》2023年第5期709-713,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨难治性甲状腺功能亢进症(甲亢)患者手术治疗适应证及临床疗效。方法回顾性分析南华大学附属南华医院2019年1月至2020年8月采用腔镜或开放手术治疗的难治性甲亢患者56例的临床资料、随访结果。结果56例患者中,男6例,女50例;腔镜手术36例(64.3%),开放手术20例(35.7%);手术时间为(132.0±32.0)min;术中出血量为(32.4±27.8)mL;术后甲状旁腺激素为(27.8±18.3)ng/L;术后病理回报良性49例(87.5%);术后出现甲状腺功能减退症14例(25.0%),其中包括甲亢合并甲状腺癌7例(12.5%),无永久性甲状旁腺功能低下、喉返神经麻痹者。所有患者预后良好,手术效果满意。结论随着甲亢术前准备方法更新、甲状腺外科技术日益成熟、新能量器械及新技术使用,对难治性甲亢或考虑恶性可能的患者,手术治疗不失为一种良好的治疗方式。Methods The clinical data and follow-up results of 56 patients with refractory hyperthyroidism who underwent laparoscopy or open surgery in Affiliated Nanhua Hospital of University of South China from January 2019 to August 2020 were retrospectively analyzed.Results Among the 56 patients,there were 6 men and 50 women.Thirty-six(64.3%)patients underwent endoscopic surgery and twenty(35.7%)patients underwent open surgery.The operation time was(132.0±32.0)minutes.Intraoperative blood loss was(32.4±27.8)mL.Postoperative parathyroid hormone level was(27.8±18.3)ng/L.Forty-nine(87.5%)patients showed benign pathology results after surgery.After surgery,14(25.0%)patients had hypothyroidism,including 7(12.5%)patients with hyperthyroidism combined with thyroid cancer.There were no patients with permanent hypothyroidism or recurrent laryngeal nerve paralysis.All patients had a good prognosis and satisfactory surgical results.Conclusion With the update of preoperative preparation methods for hyperthyroidism,the increasing maturity of thyroid surgery technology,and the use of new energy instruments and technologies,surgical treatment is undoubtedly a good treatment method for patients with refractory hyperthyroidism or a suspected malignant tumor.Objevtives To investigate the indications and clinical efficacy of surgical treatment in patients with refractory hyperthyroidism.

关 键 词：甲状腺功能亢进症 甲状腺毒症 内窥镜检查 外科手术 手术时间 失血 手术 甲状旁腺激素 手术后并发症 回顾性研究 

分 类 号：R653[医药卫生—外科学]