甲状腺次全切除术（Subtotal thyroidectomy）.docVIP

甲状腺次全切除术（Subtotal thyroidectomy） Subtotal thyroidectomy [indications] 1. Hyperthyroidism (including primary and secondary hyperthyroidism). 2. Simple goiter, a large lump, which produces compression symptoms. 3. Multiple thyroid adenomas, large thyroid adenomas or large cysts. [contraindications] 1. Small age, mild disease and no obvious thyroid enlargement. 2. Age, combined with serious heart, liver, kidney and other diseases, but difficult to tolerate the operation. [preoperative preparation] 1. Patients with hyperthyroidism, must be in internal medicine anti-thyroid medication, basal metabolic rate dropped to normal or near normal (+ 15%), pulse frequency under 90 times/min, stop taking anti-thyroid drugs, two weeks or so, take compound iodine, harden that thyroid significantly reduces, easy operation and reduce the rate of intraoperative bleeding. Specific methods for oral compound iodine liquid (Lugol liquid), 3 times a day, every time 1 day 5 drops, 6 drops every time the next day, after increasing day by day 1 drop, until to 15 drops every time, keep 3 ~ 5 surgery in the future. In recent years, it has been advocated that the patient should prepare for the operation with the compound iodine solution, and the dosage of propranolol is different from the severity of the disease. For every 6 hours, 10 to 40 mg. This can shorten the preparation time. 2. The use of sedatives can be found in the use of rumi 0.1g or valium 5mg, which can be taken orally 1 times per night. 3. Necessary preoperative examinations such as cardiovascular function and liver, renal function examination, basal metabolic determination, laryngoscopy examination of vocal cord function, X-ray examination of trachea position and blood calcium, phosphorus determination, etc. [anesthesia] Endotracheal intubation anesthesia to ensure smooth airway. [surgical procedure] 1. Position supine position, pad high shoulder, back to the head, to fully expose the neck; A small sandbag is fixed on both sides o