东部非洲乌干达巨大甲状腺肿15例诊疗分析  

Analysis of Diagnosis and Treatment of 15 Cases of Giant Goiter in Uganda,East Africa

作　　者：樊芮冰 Kintuluwaga Ronald Masereka Robert Fan Ruibing;Kintu luwaga Ronald;Masereka Robert(The Third People's Hospital of Yunnan Province,Kunming 650000,Yunnan Province,China)

机构地区：[1]云南省第三人民医院,云南省昆明市650000 [2]乌干达穆拉戈国家医院,乌千达共和国999123 [3]中乌友好医院,乌干达共和国999123

出　　处：《中国病案》2025年第1期106-109,共4页Chinese Medical Record

摘　　要：目的探讨有限资源条件下东部非洲乌干达某医院收治的直径>6厘米甲状腺肿病因、手术切除技巧及其并发症的预防。方法分析乌干达坎帕拉两家公立医院2023年10月1日-2024年3月31日期间收治的15例直径>6厘米甲状腺肿患者的临床资料,其中某国家医院10例,某友好医院5例。采用独立样本t检验比较分析两家医院患者肿块大小、手术时间、术中出血量差异,采用χ2检验比较分析两家医院患者甲状腺全切术术中情况及术后并发症发生情况差异。结果两家医院共15例良性巨大甲状腺肿患者均进行了双侧甲状腺全切术。穆拉戈某医院平均手术时间290.56分钟比友好医院253.57分钟长36.99分钟,平均出血量731.38毫升比某友好医院253.26毫升多约478.12毫升。另外,两家医院都出现术后短暂甲状旁腺功能减退、暂时性声音嘶哑,例数上无明显差别,因为两家医院均采用同样的手术方法,术后并发症无统计学差异。结论采取合理的手术方式、妥善处理甲状腺上下极、注意保护喉返神经及甲状旁腺、避免损伤颈部大血管、仔细分离结扎甲状腺血管、预防气管塌陷,在有限医疗条件情况下也可成功切除良性巨大甲状腺肿并减少并发症的发生。Objectives This study aims to discuss the etiology,surgical resection techniques,and prevention of complications of goiters>6 cm in diameter admitted to a resource-limited hospital in Uganda,East Africa.Methods Clinical data of 15 patients with goiter with a diameter greater than 6 cm admitted to two public hospitals in Kampala,Uganda between October 1,2023 and March 31,2024 were analyzed.Among them,10 cases were in a national hospital and 5 cases were in a China-Ukraine Friendship Hospital.An independent sample t-test was used to compare and analyze the differences in tumor size,operation time,and intraoperative blood loss between the two hospitals.The Chi-square test was used to compare and analyze the differences in intraoperative conditions and postoperative complications of total thyroidectomy between the two hospitals.Results A total of 15 patients with benign giant goiter in the two hospitals underwent bilateral total thyroidectomy.The average operation time of Mulago Hospital was 290.56 minutes,which was 36.99 minutes longer than that of China-Uzbekistan Friendship Hospital(253.57 minutes).The average blood loss was 731.38 ml,which was approximately 478.12 ml more than that of China-Uzbekistan Hospital(253.26 ml).In addition,both hospitals experienced transient postoperative hypoparathyroidism and temporary hoarseness,with no significant difference in the number of cases,because both hospitals used the same surgical method and there was no statistical difference in postoperative complications.Conclusions By adopting reasonable surgical methods,properly handling the upper and lower poles of the thyroid gland,paying attention to protecting the recurrent laryngeal nerve and parathyroid glands,avoiding damage to the large blood vessels in the neck,carefully separating and ligating the thyroid blood vessels,and preventing tracheal collapse,it is possible to successfully remove benign giant goiters and reduce the occurrence of complications under limited medical conditions.

关 键 词：巨大甲状腺肿 病因分析 手术方法32 

分 类 号：R653[医药卫生—外科学]