摘要
目的 探讨甲状腺术后并发症与甲状腺原发疾病、手术方式以及手术操作的关系。方法 分析我院 1990～ 2 0 0 1年间收治的 180 5例甲状腺手术患者的临床资料。结果 180 5例共发生各种术后并发症 67例 (3 .7% )。桥本病和甲状腺癌术后并发症分别为 6例 (16.2 % )和 2 7例(12 .2 % ) ,明显高于其他原发病 (P <0 .0 1,P <0 .0 5 )。初次手术行甲状腺全切术 (包括单侧和双侧 )者术后并发症 3 5例 (4 .2 % ) ,高于未行全切术者 (2 .1% ) (P <0 .0 5 ) ;初次手术操作行囊内结扎处理甲状腺下动脉分支者术后发生并发症 16例 (1.5 % ) ,低于包膜主干结扎者 (5 .9% ) (P <0 .0 1) ;保留后被膜者术后并发症 2 6例 (1.7% ) ,低于于未保留者 (16.7% ) (P <0 .0 1) ;再次手术者术后并发症 14例 (14 .6% ) ,明显高于首次手术者 (3 .1% ) (P <0 .0 1)。结论 手术治疗甲状腺疾病是安全、有效、合理可行的。提高术者素质。
Objective To investigate the relationship of postoperative complications of thyroid surgery with primary thyroid disease, operation procedures and operative manipulation. Methods The clinical data of 1805 cases of thyroid diseases treated by surgery in our department between 1990～2001 were analyzed retrospectively . Results There were 67 complications occurred in 1805 cases (3.7%). The postoperative complications rate in Hashimoto′s disease and thyroid carcinoma were 6 (16.2%) and 27 (12.2%) respectively ,which were obviously higher than that in other primary thyroid disease( P<0.01,P< 0.05 ). Postoperative complications occurred in 35 patients underwent either unilateral lobectomy or bilateral total thyroidectomy in primary operation (4.2%), which was significantly higher than that in patients underwent partial or subtotal thyroidectomy(2.1%)(P<0.05). Complications occurred in patients with thyroid inferior arteries ligated intracapsularly in primary operation ( 1.5% ) was evidently lower than that in patients with the artery ligated out of the capsule(5.9%) (P<0.01).Complications rate in patients the thyroid back capsule was retained (1.7%) was obviously lower than that in patients the back capsule not be retained (16.7%) (P<0.01%). Complication rate in reoperative patients ( 14.6% ) was markedly higher than that in patients underwent primary operation(3.1%) (P<0.01). Conclusions Surgical treatment of thyroid disease is safe, effective and feasible method. Improving the operative technique of surgeons and taking precise manipulation are the key points to reduce complications.
出处
《中国普通外科杂志》
CAS
CSCD
2003年第10期723-726,共4页
China Journal of General Surgery
