甲状腺全切除术与次全切除术在双侧甲状腺多发结节治疗中的应用
Comparison of clinical effects of total and subtotal thyroidectony in the treatment of bilateral multiple thyroid nodules
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摘要: 目的:探讨甲状腺全切除术(TT)治疗甲状腺次全切除术(ST)治疗双侧甲状腺多发结节中的临床效果。方法:对185例双侧甲状腺多发结节患者资料进行回顾分析,比较TT组与ST组患者的术中及术后情况。结果:2组患者在术中出血量、喉返神经显露方面差异均无统计学意义(P0.05);TT组手术切口及手术时间均长于ST组(P0.01),TT组甲状旁腺显露高于ST组(P0.01)。2组患者在暂时性喉返神经损伤、永久性喉返神经损伤、暂时性甲状旁腺功能低下、永久性甲状旁腺功能低下差异均无统计学意义(P0.05)。随访期间TT组患者未发现复发,ST组患者复发率为18.3%,差异有统计学意义(P0.01)。结论:在双侧甲状腺多发结节治疗方式中,TT与ST在手术安全性及近期疗效方面差异无明显不同,但在术后复发率方面TT组优于ST组,TT是种值得临床推广的手术方式。Abstract: Objective:To investigate the clinical effects of total thyroidectomy(TT) and subtotal thyroidectomy(ST) in the treatment of bilateral multiple thyroid nodules.Methods:The data of 185 cases with bilateral multiple thyroid nodules were analysed retrospectively.The surgery and postoperative situation of patients treated with TT and ST were compared.Results:The blood loss and the identification rates of recurrent laryngeal nerve of all patients were not statistically significant different(P0.05).The operative time and the mean length of incision of patients treated with TT was significant longer than these treated with ST(P0.01).The identification height of parathyroid in patients treated with TT was significantly higher than these treated with ST(P0.01).The temporary and permanent damage of recurrent laryngeal nerve and the temporary and permanent hypofunction of parathyroid of patients treated with TT,ST were not statistically significant different(P0.05).No recurrent case was found in patients treated with TT and the recurrent rate in patients treated with ST was 18.3%,which difference was statistical significance(P0.01).Conclusions:The safety of operation and recent effects of TT and ST in the treatment of bilateral multiple thyroid nodules have no obvious differences.The recurrent rate in patients treated with TT is better than these treated with ST,TT is a worthly of spreading operation method in clinic.
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