摘要
目的 :探讨甲状腺疾病再手术的原因、手术并发症及其预防。方法 :回顾性分析 43例 ( 13例良性病变 ,3 0例恶性病变 )因甲状腺疾病而再手术的病例 ,尤其注意其手术并发症的发生 ,并与同期 2 61例甲状腺恶性疾病首次手术的并发症进行比较。结果 :43例均治愈 ,3 0例恶性病变的并发症 (喉返神经的损伤 )发生率为2 0 % ,较初次手术者高 (P <0 .0 1)。结论 :初次手术方式选择和病理因素是甲状腺疾病再手术的重要原因。甲状腺再次手术时喉返神经损伤的机会明显增加 ,术中解剖并保护好喉返神经是避免其损伤的关键。甲状腺再手术时的手术风险比初次手术时大 。
Objective:To find out the morbidity of reoperation for thyroid disease, and discuss its complications and the risk factors associated with it.Method:Retrospective study. Incidence of recurrent laryngeal nerve palsy and hypoparathyroidism. This paper reported 43 cases underwent secondary thyroidectomy during the year from 1997 to 2001 in our hospital. Frozen sections were done in all cases during the operations.Result:Of the 43 cases, the initial frozen sections pathologic diagnosis were benign diseases in 30 cases, but their last pathologic diagnosis were malignent change after the first operation. Complications were 6 transient palsy of the recurrent laryngeal nerve, 2 patients developed permanent unilateral palsy and one temporary hypoparathyroidism.Conclusion:Frozen section helps to raise the accuracy of diagnosis. Secondary thyroidectomy can be avoided by selecting suitable types of operations. Subtotal thyroidectomy of benign nodular thyroid will be good for preventing reccurence. Secondary thyroidectomy should be safe procedure. Because of the high risk of complications reoperations for thyroid gland disease should be done only if the patient cannot be treated in other ways.
出处
《临床耳鼻咽喉科杂志》
CSCD
北大核心
2003年第3期147-148,共2页
Journal of Clinical Otorhinolaryngology
关键词
甲状腺疾病
再手术
并发症
Thyroid disease
Reoperation
Complications
