CAJ | 학술논문

　　目的：探讨胸骨后甲状腺肿的诊断方法和手术方式。方法：总结2000-2008年本院收治的97例胸骨后甲状腺肿患者，分析其临床表现、检查结果、手术方式、术后并发症和生存时间。结果：胸骨后甲状腺肿的主要表现为颈部肿物、呼吸不畅或呼吸困难、声音嘶哑或发音变化。65例肿瘤位于主动脉弓水平以上，32例肿瘤下界低于主动脉弓水平。颈部入路手术81例，胸骨劈开手术16例。术后并发症主要为喉返神经损伤和暂时性甲状旁腺功能低下。结论：包括CT和MRI影像学检查是胸骨后甲状腺肿的有效检查手段。颈部手术操作简便，并发症少，大部分胸骨后甲状腺肿能通过颈部手术完成，胸骨劈开手术视野好，位置低体积大或者恶性肿瘤应该考虑胸骨劈开手术。
　　목적：탐토흉골후갑상선종적진단방법화수술방식。방법：총결2000-2008년본원수치적97례흉골후갑상선종환자，분석기림상표현、검사결과、수술방식、술후병발증화생존시간。결과：흉골후갑상선종적주요표현위경부종물、호흡불창혹호흡곤난、성음시아혹발음변화。65례종류위우주동맥궁수평이상，32례종류하계저우주동맥궁수평。경부입로수술81례，흉골벽개수술16례。술후병발증주요위후반신경손상화잠시성갑상방선공능저하。결론：포괄CT화MRI영상학검사시흉골후갑상선종적유효검사수단。경부수술조작간편，병발증소，대부분흉골후갑상선종능통과경부수술완성，흉골벽개수술시야호，위치저체적대혹자악성종류응해고필흉골벽개수술。
Objective:To investigate the clinical characteristics diagnosis and surgical treatment of substemal goiter. Method:The clinical data of 97 csese with substernal goiters were retrospectively analyzed from 2000 to 2008 in our hospital. The clinical manifestations,examination results,operative method,complications and prognosis were analysised. Resut:The main symptoms of substernal goiter were cervical mass,poor breath or dyspnea,speech change or hoarseness. In 65 cases the tumors were located in the aortic arch level above,and 32 cases the tumor lower below the aortic arch level. The cervical approach was performed in 81 cases,sternum-splitting approach was performed in 16 cases. The major postoperative complication was recurrent laryngeal nerve injury and temporary hypoparathyroidism. Conclusion:Imaging examinations including the CT and MRI is the effective method for substernal goiter. The cervical approach is simple and safety,most substernal goiters can be removed by cervical approach. Sternum-splitting could get enough operation field and be fit for the large and lower tumor or the malignant tumor.