摘要
目的探讨经胸乳途径腔镜手术治疗甲状腺功能亢进52例患者的临床疗效。方法自2008年10月～2010年9月,对52例原发甲亢患者实施经胸乳腔镜下甲状腺次全切除术进行回顾性分析。结果腔镜下完成手术47例。中转开放手术5例,其中3例因术中出血难以控制,2例因甲状腺体积太大,手术操作空间不够而中转。平均手术时间:115min(90～250min),术中平均出血量35ml(25～75ml),术后2～3d拔除颈部引流管,术后平均住院5d(4～6d),术后发生一过性声音嘶哑2例,发生胸前皮下瘀斑3例,均在术后短期内恢复。无喉上神经、喉返神经及甲状旁腺损伤临床表现。46例术后随访12～24个月。术后出现18例甲状腺功能低下,16例为暂时性甲状腺功能低下,3个月后恢复正常,2例3个月后甲状腺功能仍未恢复正常,需每天口服左旋甲状腺素维持甲状腺正常功能。无甲亢症状复发病例,所有患者对术后美容效果非常满意。结论经胸乳入路腔镜甲状腺切除术治疗原发性甲亢是安全、有效、美容好的外科治疗新方法。
Objective To investigate the effect of patients with primary hyperthyroidism treated by endoscopic surgery through anterior chest and breast approach.Methods From October 2008 to September 2010,.52 cases with primary hyperthyroidism underwent endoscopic subtotal thyroidectomy via anterior chest and breast approach after failure in receiving standardized internal medical treatment over two years.Results Endoscopic operations were finished in 47 cases.The other 5 cases were transferred to open operation because of uncontrollable massive bleeding in 3 cases and limited operative field cause by huge thyroids in 2 cases..The mean operative time was 115 minutes（90～250 min）,and the mean volumn of intraoperative blood loss was 35 ml（25～75 ml）.Neck drainage tube was removed in 2～3 days after operation..The mean postoperative hospitalization time was 5 days.（range from 4～6 days）.No injuries of superior laryngeal nerve,recurred laryngeal nerve and parathyroid occurred.Postoperative follow-up was got in 46 cases ranged from 12～24 months.Eighteen cases occurred hypothyroidism after operation.Among them,.16 cases were mild temporary hypothyroidism,two cases occurred severe hypothyroidism and the levothyroxine sodium was given to maintain the thyroid function..No recurrent hyperthyroidism was found after operation..All cases were satisfactory for postoperative cosmetic result.Conclusion Endoscopic operation is a safe,effective,minimally invasive and cosmetic new method for treating primary hyperthyroidism.
出处
《岭南现代临床外科》
2011年第6期442-444,共3页
Lingnan Modern Clinics in Surgery
