摘要
目的:探讨甲状腺全切术和次全切术治疗甲状腺多发结节临床疗效和预后.方法:回顾性分析本院2016年3月至2017年8月90例甲状腺多发结节患者,根据手术方式分为全切术组(n=45)和次全切术组(n=45),全切术组患者经甲状腺全切术治疗,次全切术组经甲状腺次全切术治疗,比较两组患者临床疗效及预后情况.结果:全切术组患者手术时间、住院总时间均长于次全切术组,切口长度长于次全切术组,镇痛剂使用量多于次全切术组(P<0.05);全切术组患者术后游离三碘甲状腺原氨(FT3)、游离甲状腺素(FT4)含量低于次全切术组(P<0.05);两组患者手术前后甲状旁腺功能指标比较(P>0.05);全切术组患者并发症发生率17.78%高于次全切术组4.44%(P<0.05);术后1年,全切术组复发率低于次全切术组(P<0.05).结论:甲状腺多发结节患者应用甲状腺次全切术对其甲状腺功能的损伤均较小,术后并发症发生率低,而采用甲状腺全切术术后复发率低,两种术式各有优势.
Objective: To explore the clinical efficacy and prognosis effects of patients with multiple thyroid nodules treated by total thyroidectomy and subtotal thyroidectomy. Methods: Ninety patients with multiple thyroid nodules in our hospital from March 2016 to August 2017 were retrospectively analyzed. They were divided into total thyroidectomy group (n = 45) and subtotal thyroidectomy group (n = 45). Total thyroidectomy group was treated by total thyroidectomy, and subtotal thyroidectomy group was treated by subtotal thyroidectomy. The clinical efficacy and prognosis of the two groups were compared. Results: The operative time and total hospital stay in total thyroidectomy group were longer than those in subtotal thyroidectomy group, and the length of incision was longer than that in subtotal thyroidectomy group, and the usage amount of analgesics was more than that in subtotal thyroidectomy group (P<0.05). The postoperative thyroid function indexes of free triiodothyronine (FT3) and free thyroxine (FT4) in total thyroidectomy group were lower than those in subtotal thyroidectomy group (P<0.05). There was no statistically significant difference in parathyroid gland function indexes between the two groups before and after surgery (P>0.05). The incidence rate of complications in total thyroidectomy group was higher than that in subtotal thyroidectomy group (17.78% vs 4.44%)(P<0.05). At 1 year after operation,the recurrence rate of total resection group was lower than that of subtotal resection group, and the difference was statistically significant (P<0.05). Conclusions: Subtotal thyroidectomy for patients with multiple thyroid nodules has less damage to their thyroid function and lower incidence of complications, while total thyroidectomy for patients with multiple thyroid nodules has lower recurrence rate. Both methods have their own advantages.
作者
王乃金
应浩杰
史进
周文广
马军伟
苏珂
WANG Naijin;YING Haojie;SHI Jin(Zibo Hospital in 960 Hospital of PLA, Shandong Zibo 255300, China)
出处
《河北医学》
CAS
2019年第8期1368-1371,共4页
Hebei Medicine
基金
山东省医药卫生科技发展计划项目,(编号:2016WS03217)
