摘要目的 探讨改良甲状腺次全切除术(边切边缝法)治疗甲状腺功能亢进症(甲亢)、良性甲状腺肿块的疗效及临床应用.方法 对170例患者分别用改良法(90例),传统术式(80例),行甲状腺次全切除手术.改良法:小切口,不离断颈前肌群,由下极开始边切边缝,操作在甲状腺被膜内进行,不进入气管食管间沟,随时调整切除及保留的大小.结果 改良法90例术后声音嘶哑2例,发生饮水呛咳2例,l周后均恢复正常;出现甲状旁腺功能低下1例,4 d后消失;无甲状腺危象等并发症;常规法80例术后声音嘶哑6例,发生呛咳5例,出现甲状旁腺功能低下5例;改良法与常规法引起神经和甲状旁腺损伤的比较,有显著性差异(P<0.01).结论 甲状腺次全切除采用改良法能减少出血和手术时间,减少神经及甲状旁腺的损伤.

abstractsObjective To investigate the improvement of thyroid sub-total resection (edge trimming slit method) in treatment of hyperthyroidism, benign thyroid mass effect and clinical application. Methods 170 patients were used to Improvement Act (90 cases), the traditional surgical (80 cases), subtotal thyroidectomy with resection. Improvement Act: a small incision, anterior cervical muscles be separated off from the very start the next seam edge trimming operation in the thyroid by membrane, not in a groove between the esophagus into the trachea at any time to adjust the size of the removal and retention. Results The improved method of 90 cases of postoperative hoarseness in 2 cases occurred two cases of drinking water, choking, 1 weeks later returned to normal; one cases of hypoparathyroidism occurs,4 d later disappeared; no complications such as thyroid storm;conventional method 80 6 cases of postoperative hoarseness, cough occurred in 5 cases,5 cases of hypoparathyroidism occurred; improved method and conventional method caused more nerve and parathyroid injury, there is a significant difference (P<0.01). Conclusion The subtotal thyroidectomy with modified method can reduce bleeding and surgical time, reduce nerve and parathyroid damage.