摘要
目的探讨胸骨后甲状腺疾病的临床表现、诊断和手术治疗。方法回顾性分析1999年1月—2008年1月手术治疗32例胸骨后甲状腺肿的临床资料。结果临床表现主要为无症状颈部肿物20例,颈部肿物伴随憋气6例,伴随甲亢和声音嘶哑各3例。25例为坠入性胸骨后甲状腺肿,7例为胸内甲状腺肿。良性病变28例,恶性或伴随恶性病变4例。29例采用颈前部低领式切口,3例采用颈胸联合切口。行甲状腺大部切除29例,甲状腺癌根治术3例。手术后声音嘶哑恢复正常2例,声音嘶哑无改善1例。一过性手足抽搐6例。结论多数胸骨后甲状腺肿是颈前部病变向下的延续,颈胸部CT检查是最有效的检查手段。多数病人手术可以经颈部低领式切口完成,必要时行颈胸联合切口。
Objective To investigate the clinical characteristics, diagnosis and surgical treatment of substemai goiter. Methods Clinical data of 32 cases of subternal goiter from Jan 1999 to Jan 2008 were retrospectively analyzed. Results The main symptoms of substemal goiter were asymptomatic cervical mass in 20 patients, airway obstruction in 6 ones, and hyperthyroidism and hoarseness in 3 ones, respectively. There were 25 cases of descending substcrual goiter and 7 cases of truly intrathoracic thyroid. Pathology identified benignity in 28 cases and malignancy in 4 ones. Operation were performed in 29 cases through low cervical incision and in 3 ones with combined Ccrvici-stcnotomic approach. Subtotal thyroideetomy was performed in 29 cases, and 3 ease of thyroid cancer received radical resection. Postoperative hoarseness disappeared in 2 patients, while it did not improve in I case. Six patients experienced transient hypocalcemia after operation. Conclusion Substernal goiters often result from the descent of a cervical goiter. CT scanning of neck and thorax is valuable in the diagnosis of substernal goiters. Most substernal goiters can be removed through a transcervical approach, although combined cervici-steruotomic approach is occasionally required.
出处
《临床军医杂志》
CAS
2008年第5期747-748,共2页
Clinical Journal of Medical Officers
