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目的探讨87例甲状腺患者的术前检查,全甲状腺切除手术过程及术后病理学诊断、术后治疗情况。方法回顾性分析同济医院分院在2002年—2009年收治甲状腺患者87例,行全甲状腺切除术中采用精细操作,根据全甲状腺切除术的适用范围对不能签别的甲状旁腺采用快速冰冻活组织检查、确认为甲状旁腺后将其移植在同侧胸锁乳突肌内。至关重要的是手术中仔细解剖喉返神经而不使该神经损伤。认真鉴别喉上神经的外侧支及舌下神经降支和交感神经与喉返神经的吻合支。结果 87例甲状腺患者通过全甲状腺切除术治疗后,仅有18例出现低血钙,2例患者有喉返神经损伤,该组患者术后均采用甲状腺片(80～160mg/d)或左旋甲状腺素片(50～150mg/d)终生替代治疗。结论全甲状腺切除术降低了再手术率,也是实施131I治疗所必须的。
Objective To investigate the preoperative examination, total thyroidectomy and postoperative pathological diagnosis and postoperative treatment in 87 thyroid patients. Methods Retrospective analysis of Tongji Hospital Branch in 2002-2009, 87 cases of thyroid patients admitted to the Department of Thyroidectomy with fine operation, according to the scope of application of total thyroidectomy can not sign the parathyroid rapid frozen tissue Check, confirmed as parathyroid after its transplantation in the ipsilateral sternocleidomastoid muscle. It is critically important that the recurrent laryngeal nerve be carefully dissected during surgery without damaging the nerve. Carefully identify the lateral branch of the laryngeal nerve and hypoglossal nerve and sympathetic nerve and recurrent laryngeal nerve anastomosis. Results After thyroidectomy in 87 thyroid patients, there were only 18 cases with hypocalcemia and 2 cases with recurrent laryngeal nerve injury. Thyroid gland (80 ~ 160 mg / d) or left thyroid Vegetarian tablets (50 ~ 150mg / d) lifetime replacement therapy. Conclusions Total thyroidectomy reduces the rate of reoperation and is necessary for the implementation of 131I.