摘要
目的探讨保留上极的甲状腺次全切除术的临床疗效及预防术后并发症的有效方法。方法对120例患者分别用改良法(60例),传统术式(60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60例术后声音嘶哑2例,发生饮水呛咳1例,1周后均恢复正常;出现甲状旁腺功能低下1例,4d后消失;无甲状腺危象等并发症;常规法60例术后声音嘶哑6例,发生呛咳4例,出现甲状旁腺功能低下4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)。结论保留上极的甲状腺次全切除术既可减少和预防对甲状旁腺的损伤,又可保障甲状旁腺的血液供应,具有安全,灵活性强,操作简便,节省时间,手术疗效确切,可有效地减少和预防了术后并发症等特点,值得临床推广使用。
Objective To investigate the retention of the upper pole of thyroid resection of clinical efficacy and effective way to prevent postoperative complications.Methods In 120 patients,respectively,with the modified method（60 cases）,the traditional operation（60 cases）,subtotal thyroidectomy surgery.Improvement Act： a small incision,leave off the anterior muscles,from the very beginning under the seam edge trimming operation is in the thyroid membrane,not in the groove between the esophagus into the trachea,at any time and keep adjusting the size of excision.Results Improved method of 60 cases of postoperative hoarseness in 2 cases,drinking water,choking occurred in 1 case,returned to normal after 1 week;appear hypoparathyroidism one case,4d disappear;no complications such as thyroid storm;conventional method 60 patients 6 cases of postoperative hoarseness,cough occurred in 4 cases,there hypoparathyroidism in 4 cases;improved method and conventional method caused more nerve and parathyroid injury,there is a significant difference（P0.01）.Conclusions Keep the upper pole of thyroid resection can reduce and prevent damage to the parathyroid gland,parathyroid glands can also protect the blood supply is safe,flexible,easy to operate,save time,surgery is effective,can effectively reduce and prevent postoperative complications,etc.worthy of clinical use.
出处
《医药论坛杂志》
2011年第23期103-104,共2页
Journal of Medical Forum
