| 摘要: |
| ［摘要］ 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。 |
| 关键词: 巨大甲状腺肿 手术治疗 并发症 |
| DOI：10.3969/j.issn.1674-3806.2015.04.11 |
| 分类号:R 581.3 |
| 基金项目: |
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| Experience on surgical treatment of 50 patients with huge goiter |
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ZHANG Ya-feng, ZHANG Rui-ming
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Department of General Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China
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| Abstract: |
| ［Abstract］ 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 thyroidectomy, 2 patients underwent total thyroidectomy plus prophylactic peripheral lymph nodes(PLN) dissection. Pathologic diagnosis showed nodular goiter in 39 cases, carcinoma of thyroid in 8 cases, secondary hyperthyroidism in 3 cases. 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 patients according to their different conditions and to prevent the injuries of blood vessels, recurrent laryngeal nerve and parathyroid. |
| Key words: Huge goiter Surgical treatment Complication |
