CAJ | 학술논문

目的：探讨巨大甲状腺肿的临床特点与治疗要点。方法收集内蒙古医科大学附属医院普外科2010-06～2012-06收治的肿块直径8 cm以上的50例巨大甲状腺肿患者的临床资料进行回顾性研究。结果30例行甲状腺一侧腺叶切除加对侧叶大部切除术，14例行甲状腺一侧腺叶切除术，4例行甲状腺全切除术，2例行甲状腺全切除术加颈部淋巴结清扫术。病理诊断为单纯性结节性甲状腺肿39例，甲状腺癌8例，继发甲亢者3例。术后出现短暂并发症者16例，其中术后出现甲状腺功能低下8例，甲状旁腺功能低下4例，声音嘶哑3例，术后出血1例。无死亡病例。结论巨大甲状腺肿常常合并胸骨后甲状腺肿，压迫气管，使气管变窄移位，手术操作困难，风险较高。根据不同的情况做不同处理，避免大血管和喉返神经及甲状腺旁腺的损伤。
목적：탐토거대갑상선종적림상특점여치료요점。방법수집내몽고의과대학부속의원보외과2010-06～2012-06수치적종괴직경8 cm이상적50례거대갑상선종환자적림상자료진행회고성연구。결과30례행갑상선일측선협절제가대측협대부절제술，14례행갑상선일측선협절제술，4례행갑상선전절제술，2례행갑상선전절제술가경부림파결청소술。병리진단위단순성결절성갑상선종39례，갑상선암8례，계발갑항자3례。술후출현단잠병발증자16례，기중술후출현갑상선공능저하8례，갑상방선공능저하4례，성음시아3례，술후출혈1례。무사망병례。결론거대갑상선종상상합병흉골후갑상선종，압박기관，사기관변착이위，수술조작곤난，풍험교고。근거불동적정황주불동처리，피면대혈관화후반신경급갑상선방선적손상。
Objective To investigate the clinical characteristics of huge goiter and main problems of surgical treatment for huge goiter .Methods A respective study was performed in 50 patients with huge goiter whose diameter was larger than 8 cm, during June 2010~June 2012 .Results Thirty patients underwent one lobe thyroidectomy plus one lobe subtotal thyroidectomy , 14 patients underwent one lobe thyroidectomy , 4 patients underwent total thyroidec-tomy, 2 patients underwent total thyroidectomy plus prophylactic peripheral lymph nodes (PLN) dissection.Patholog-ic diagnosis showed nodular goiter in 39 cases, carcinoma of thyroid in 8 cases, secondary hyperthyroidism in 3 ca-ses.Postoperative complications were found in 16 cases, including hypothyroidism in 8 cases, hypoparathyroidism in 4 cases, huarseness in 3 cases, postoperative bleeding in 1 case.No death occurred.Conclusion Huge goiter was usually complicated by substernal goiter , causing tracheal compression , narrow and displacement , so operation for huge goiter is relatively difficult with correspondingly high operation risk and morbidity .It is necessary to treat the pa-tients according to their different conditions and to prevent the injuries of blood vessels , recurrent laryngeal nerve and parathyroid .