49例甲状腺疾病手术治疗临床观察(1)
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[摘要] 目的 探讨外科手术治疗甲状腺疾病临床效果。 方法 回顾性分析本院2008年3月～2011年5月行外科手术治疗甲状腺疾病患者49例的临床治疗资料及随访观察结果。 结果 49例患者均顺利度过围术期，康复出院；无术中死亡，甲状腺危象及窒息等发生；7例患者术后出现并发症，其中，切口感染3例，术后出血1例，声音嘶哑1例，手足抽搐2例；术后随访2～3年，所有患者均得到随访，随访率为100%；2例患者出现复发，行二次手术，其中，髓样癌1例，乳头状癌1例。 结论 外科手术是临床治疗甲状腺疾病特别是甲状腺肿瘤的有效手段之一；术前准确诊断，术中严格遵循手术原则及熟练操作能够有效提高手术成功率，减少术后并发症，降低复发率。
[关键词] 甲状腺疾病；手术治疗；并发症；临床观察
[中图分类号] R581 [文献标识码] A [文章编号] 1674-4721(2012)02(c)-0024-02
Clinical observation of surgery in the treatment of thyroid disease in 49 cases
XU Yanting BAO Huadong
Daojiao Hospital of Dongguan City in Guangdong Province, Dongguan 523176, China
[Abstract] Objective To evaluate the clinical effect of surgery in the treatment of thyroid disease. Methods The clinical data of 49 patients with thyroid disease who were treated with surgery and follow-up observation results were analyzed retrospectively in our hospital from March 2006 to May 2008. Results Forty nine patients all lived the perioperative period successfully, who had no intraoperative deaths, thyroid storm and asphyxia. 7 cases had complications after surgery, among whom 3 cases of wound infection, 1 case of postoperative bleeding, 1 case of hoarseness, 2 cases of tetany were included. All patients were followed up for 2-3 years, the followed-up rate was 100%. 2 cases had recurrence and underwent secondary surgery, 1 case of medullary carcinoma and 1 cases of papillary carcinoma were included. Conclusion Surgical treatment is the effective method in the treatment of thyroid diseases especially for thyroid cancer in clinic. Accurate preoperative diagnosis, strictly following the surgical principle and proficient operation can effectively improve the success rate of surgery, reduce the postoperative complication and lower recurrence rate.
[Key words] Thyroid disease; Surgery; Complication; Clinical observation
甲状腺疾病主要有甲状腺功能亢进症(简称甲亢)、甲状腺功能低下症(简称甲低或甲减)、甲状腺瘤、甲状腺炎、甲状腺囊肿、甲状腺功能亢进并发症等，是临床常见内分泌系统疾病之一，其种类较多，女性发病率明显高于男性[1]；内科药物治疗效果不佳，难以从根本上消除病症[2]，长期发展易引起严重并发症，从而危及患者的生命；目前外科手术治疗已成为临床甲状腺疾病首选治疗手段[3]。笔者回顾性分析本院2008年3月～2011年5月行外科手术治疗甲状腺疾病患者49例的临床治疗资料，现报道如下：
1 资料与方法
1.1 一般资料
入选患者为2008年3月～2011年5月本院收治行外科手术治疗的甲状腺疾病患者，共49例，其中，男13例，女36例，年龄19～76岁，平均41.6岁；患病时间1～7年，平均2.4年。患者中甲状腺腺瘤10例，甲状腺囊肿5例，桥本甲状腺炎8例，甲状腺功能亢进症5例，乳头状癌10例，髓样癌6例，未分化癌5例；其中6例术前合并有基础疾病 ......
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