CAJ | 학술논문

目的：探讨精细化甲状腺被膜解剖法在良性甲状腺疾病再次手术中的应用价值。方法2009年3月-2014年12月，我院共收治88例良性甲状腺疾病术后复发患者，A组42例按传统手术方法进行手术，B组46例按精细化甲状腺被膜解剖法进行手术，两组均行甲状腺全切术，比较两组术后饮水呛咳、暂时性喉返神经麻痹、永久性喉返神经损伤、暂时性甲状旁腺功能减退及永久性甲状旁腺功能减退发生率。结果 A组喉上神经损伤1例，暂时性喉返神经麻痹4例，永久性喉返神经损伤1例，暂时性甲状旁腺功能低下9例；B组喉上神经损伤1例，暂时性喉返神经麻痹2例，永久性喉返神经损伤1例，暂时性甲状旁腺功能低下2例。两组均无永久性甲状旁腺功能低下发生。A组并发症15例(35.7%)，B组并发症6例(13%)(P＜0.05)。结论良性甲状腺疾病再次手术术后并发症发生率高，精细化甲状腺被膜解剖法能够降低并发症发生率。
목적：탐토정세화갑상선피막해부법재량성갑상선질병재차수술중적응용개치。방법2009년3월-2014년12월，아원공수치88례량성갑상선질병술후복발환자，A조42례안전통수술방법진행수술，B조46례안정세화갑상선피막해부법진행수술，량조균행갑상선전절술，비교량조술후음수창해、잠시성후반신경마비、영구성후반신경손상、잠시성갑상방선공능감퇴급영구성갑상방선공능감퇴발생솔。결과 A조후상신경손상1례，잠시성후반신경마비4례，영구성후반신경손상1례，잠시성갑상방선공능저하9례；B조후상신경손상1례，잠시성후반신경마비2례，영구성후반신경손상1례，잠시성갑상방선공능저하2례。량조균무영구성갑상방선공능저하발생。A조병발증15례(35.7%)，B조병발증6례(13%)(P＜0.05)。결론량성갑상선질병재차수술술후병발증발생솔고，정세화갑상선피막해부법능구강저병발증발생솔。
Objective To explore the value of meticulous capsular dissection technique in re-operation of thyroid under benign condition.MethodsFrom March 2009 to December 2014, 88 patients with recurrence after surgery for benign thyroid disorders were treated in our hospital. All cases were divided into two groups: group A (n=42) and group B (n=46). All patients had undergone total thyroidectomy, while patients in group A were treated with traditional surgery and patients in B group were refined by thyroid surgery membrane dissection. The incidence rate of drinking cough, temporary RLNP, permanent recurrent laryngeal nerve injury, temporary hypoparathyroidism and permanent hypoparathyroidism were compared in two groups.Results In group A, 1 case was laryngeal nerve injury, 4 cases were temporary recurrent laryngeal nerve palsy, 1 case was permanent recurrent laryngeal nerve injury, and 9 cases were temporary hypoparathyroidism. In group B, 1 case was laryngeal nerve injury, 2 cases were temporary recurrent laryngeal nerve palsy, 1 case was permanent recurrent laryngeal nerve injury, 2 cases were temporary hypoparathyroidism. Permanent hypoparathyroidism were not found in both groups. Fifteen cases with complications were found in group A (35.7%) and 6 cases with complications were in group B (13%) (P<0.05).Conclusion The meticulous capsular dissection technique indicate lower incidence of postoperative complications than reoperation for benign thyroid disease, which is worthy of clinical popularization and application.