中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2010年
4期
94-95
,共2页
改良甲状腺次全切除术%传统术式%临床应用
改良甲狀腺次全切除術%傳統術式%臨床應用
개량갑상선차전절제술%전통술식%림상응용
Modified subtotal thyroidectomy surgery%Traditional operation%Clinical application
目的 探讨改良甲状腺次全切除术(边切边缝法)治疗甲状腺功能亢进症(甲亢)、良性甲状腺肿块的疗效及临床应用.方法 对170例患者分别用改良法(90例),传统术式(80例),行甲状腺次全切除手术.改良法:小切口,不离断颈前肌群,由下极开始边切边缝,操作在甲状腺被膜内进行,不进入气管食管间沟,随时调整切除及保留的大小.结果 改良法90例术后声音嘶哑2例,发生饮水呛咳2例,l周后均恢复正常;出现甲状旁腺功能低下1例,4 d后消失;无甲状腺危象等并发症;常规法80例术后声音嘶哑6例,发生呛咳5例,出现甲状旁腺功能低下5例;改良法与常规法引起神经和甲状旁腺损伤的比较,有显著性差异(P<0.01).结论 甲状腺次全切除采用改良法能减少出血和手术时间,减少神经及甲状旁腺的损伤.
目的 探討改良甲狀腺次全切除術(邊切邊縫法)治療甲狀腺功能亢進癥(甲亢)、良性甲狀腺腫塊的療效及臨床應用.方法 對170例患者分彆用改良法(90例),傳統術式(80例),行甲狀腺次全切除手術.改良法:小切口,不離斷頸前肌群,由下極開始邊切邊縫,操作在甲狀腺被膜內進行,不進入氣管食管間溝,隨時調整切除及保留的大小.結果 改良法90例術後聲音嘶啞2例,髮生飲水嗆咳2例,l週後均恢複正常;齣現甲狀徬腺功能低下1例,4 d後消失;無甲狀腺危象等併髮癥;常規法80例術後聲音嘶啞6例,髮生嗆咳5例,齣現甲狀徬腺功能低下5例;改良法與常規法引起神經和甲狀徬腺損傷的比較,有顯著性差異(P<0.01).結論 甲狀腺次全切除採用改良法能減少齣血和手術時間,減少神經及甲狀徬腺的損傷.
목적 탐토개량갑상선차전절제술(변절변봉법)치료갑상선공능항진증(갑항)、량성갑상선종괴적료효급림상응용.방법 대170례환자분별용개량법(90례),전통술식(80례),행갑상선차전절제수술.개량법:소절구,불리단경전기군,유하겁개시변절변봉,조작재갑상선피막내진행,불진입기관식관간구,수시조정절제급보류적대소.결과 개량법90례술후성음시아2례,발생음수창해2례,l주후균회복정상;출현갑상방선공능저하1례,4 d후소실;무갑상선위상등병발증;상규법80례술후성음시아6례,발생창해5례,출현갑상방선공능저하5례;개량법여상규법인기신경화갑상방선손상적비교,유현저성차이(P<0.01).결론 갑상선차전절제채용개량법능감소출혈화수술시간,감소신경급갑상방선적손상.
Objective To investigate the improvement of thyroid sub-total resection (edge trimming slit method) in treatment of hyperthyroidism, benign thyroid mass effect and clinical application. Methods 170 patients were used to Improvement Act (90 cases), the traditional surgical (80 cases), subtotal thyroidectomy with resection. Improvement Act: a small incision, anterior cervical muscles be separated off from the very start the next seam edge trimming operation in the thyroid by membrane, not in a groove between the esophagus into the trachea at any time to adjust the size of the removal and retention. Results The improved method of 90 cases of postoperative hoarseness in 2 cases occurred two cases of drinking water, choking, 1 weeks later returned to normal; one cases of hypoparathyroidism occurs,4 d later disappeared; no complications such as thyroid storm;conventional method 80 6 cases of postoperative hoarseness, cough occurred in 5 cases,5 cases of hypoparathyroidism occurred; improved method and conventional method caused more nerve and parathyroid injury, there is a significant difference (P<0.01). Conclusion The subtotal thyroidectomy with modified method can reduce bleeding and surgical time, reduce nerve and parathyroid damage.
