摘要目的 探讨胸骨后甲状腺肿的诊断、手术及并发症的预防和处理.方法 回顾性分析经外科手术病理证实的22例胸骨后甲状腺肿患者的临床资料.结果 22例中结节性甲状腺肿10例,甲状腺腺瘤7例,结节性甲状腺肿癌变3例,甲状腺乳头状癌伴气管旁淋巴结转移1例,甲状腺滤泡状腺癌伴气管旁淋巴结和纵隔淋巴结转移1例.20例颈部低位领式切口入路切除,2例颈部低位领式切口并胸骨正中劈开入路.术后并发症发生率为22.7%.22例胸骨后甲状腺肿物患者术后1～5年随访无复发.结论 胸骨后甲状腺肿术前行CT和MRI有助手术入路的选择;颈部低位领状切口手术对大多数胸骨后甲状腺肿是一种安全可靠并可行的选择.

abstractsObjective To study the diagnosis, surgical approaches and prevention of complications for substernal goiter. Methods A retrospective study of 22 cases of substernal thyroid nodules was made. Results Among the 22 cases, 10 cases were nodular goite, 7 cases were adenomas,3 cases were nodular goiter canceration,1 case was papillary thyroid car-cinoma with lymph node metastases adjacent to the trachea. Resection via cervical collar incision was adequate in 20 cases.Thyroid cancers with paratracheal node,2 cases were resected by combined thoracotomy and cervical collar incision. The rate of complication after operation was 22.7%. There was no relapse among all patients through 1-5 years followed-up. Con-clusions CT and MRI can help to make correct operational program. Resection viacervical collar incision for all retrosternal thyroid nodules are advised for its safe and reliable.