甲状腺肿瘤术后呼吸困难处理专家共识  

Expert consensus on the management of postoperative dyspnea following thyroid tumor surgery

作　　者：中国医药教育协会头颈肿瘤专业委员会 中国抗癌协会甲状腺癌专业委员会 中国医师协会耳鼻咽喉分会头颈外科学组 四川省医学会甲状腺疾病专业委员会 李超[2] 苗素生[3] 郑向前 安常明[5] 李小毅[6] 宋明[7] 王宇 蔡永聪[9] 郭伦华 孙荣昊[9] 汪旭 杨宪广[3] 张思诚 Head and Neck Tumor Specialty Committee of Chinese Pharmaceutical Education Association;Thyroid Cancer Specialty Committee of China Anti-cancer Association;Head and Neck Surgery Group of the Otorhinolaryngology Society of the Chinese Medical Doctor Association;Thyroid Disease Specialty Committee of the Sichuan Medical Association;Li Chao(不详;Department of Head and Neck Surgery,Sichuan Cancer Hospital,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,University of Electronic Science and Technology of China,Chengdu 610041,China)

机构地区：[1]不详 [2]四川省肿瘤医院头颈外科、四川省肿瘤临床医学研究中心、四川省肿瘤医院·研究所、四川省癌症防治中心、电子科技大学附属肿瘤医院,成都610041 [3]哈尔滨医科大学附属肿瘤医院头颈外科 [4]天津市肿瘤医院甲状腺颈部肿瘤科 [5]中国医学科学院肿瘤医院头颈外科 [6]北京协和医院基本外科 [7]中山大学肿瘤防治中心头颈科 [8]复旦大学附属肿瘤医院头颈外科 [9]四川省肿瘤医院头颈外科

出　　处：《中华医学杂志》2025年第14期1055-1067,共13页National Medical Journal of China

基　　金：国家科技重大专项(2024ZD0525605);四川省卫生健康委员会项目(24LCYJPT06)。

摘　　要：近年来,甲状腺肿瘤的发病率显著上升,其中甲状腺癌已成为头颈部最常见的恶性肿瘤。手术是甲状腺肿瘤的主要治疗方式,而术后呼吸困难则是其严重并发症之一,虽然其总体发生率较低,但病因复杂且病情紧急,严重时可危及生命。目前国内外尚缺乏针对该并发症的围手术期统一操作规范和指导意见。为降低术后呼吸困难的发生率并提高治疗效果,同时提升甲状腺肿瘤手术的质控水平,中国医药教育协会头颈肿瘤专业委员会、中国抗癌协会甲状腺癌专业委员会、中国医师协会耳鼻咽喉分会头颈外科学组、四川省医学会甲状腺疾病专业委员会组织国内头颈外科、甲状腺外科、普通外科、耳鼻咽喉科、肿瘤外科、麻醉科等相关科室90余名专家,通过系统文献回顾、循证分析和多轮专家讨论,围绕甲状腺肿瘤术后呼吸困难的病因、监测、评估及处理等方面达成共识,并提出17条推荐意见,以期为临床实践提供科学参考与规范指导。In recent years,the incidence of thyroid tumor has risen significantly,and thyroid cancer has emerged as one of the most common malignant tumors in the head and neck region.Surgery remains the primary treatment for thyroid tumors,but postoperative dyspnea still occurs occasionally and becomes a serious complication.Although its incidence is relatively low,the underlying causes are complex,and severe cases can be life-threatening.Currently,there are no standardized perioperative protocols or guidelines available,either domestically or internationally.To address this gap,the Head and Neck Tumor Specialty Committee of Chinese Pharmaceutical Education Association,the Thyroid Cancer Specialty Committee of China Anti-cancer Association,the Head and Neck Surgery Group of the Otorhinolaryngology Society of the Chinese Medical Doctor Association,and the Thyroid Disease Specialty Committee of the Sichuan Medical Association convened a multidisciplinary panel of over 90 experts from different fields including head and neck surgery,thyroid surgery,general surgery,otolaryngology surgery,oncologic surgery,and anesthesiology.Through a systematic literature review,evidence appraisal,and multiple rounds of expert discussions,a consensus was reached on the etiology,monitoring,assessment,and management of postoperative dyspnea in thyroid tumor patients.This expert consensus comprises 17 key recommendations,aiming to provide scientific reference and standardized guidance for clinical practice.

关 键 词：甲状腺肿瘤 外科治疗 呼吸困难 评估 治疗 

分 类 号：R736.1[医药卫生—肿瘤]