改良小切口手术治疗青少年原发性甲状腺功能亢进症96例临床体会.doc

改良小切口手术治疗青少年原发性甲状腺功能亢进症96例临床体会[摘要] 目的:探讨改良小切口手术治疗青少年原发性甲亢患者的优点及可行性,推广小切口治疗青少年原发性甲亢的治疗方法。方法:我院2000年1月～2007年1月采用改良小切口对96例经抗甲状腺药物治疗效果欠佳的青少年甲亢患者施行手术,术后追踪2～5年的临床实践资料。结果:本组96例疗效满意,瘢痕小,并发症少。结论:改良小切口治疗青少年原发性甲亢是一种安全、有效的治疗方法,能达到治疗目的,且切口美观,值得推广。 [关键词] 甲亢;小切口;手术 [中图分类号]R581.1 [文献标识码] B[文章编号] 1673-7210(2009)07(c)-154-02 Clinical experience of the improvement of 96 cases of young people with primary hyperthyroidism and thyroid via improved small-incision surgery HUANG Junxiao, LI Yuhong, HE Wudong, LI Quanrong (Wuchuan People’s Hospital of Guangdong Province, Wuchuan 524500, China) [Abstract] Objective: To investigate the merits and feasibility of minimally invasive treatment of improved small-incision surgery in patients with primary hyperthyroidism, and promote young people’s treatment of primary hyperthyroidism. Methods: 96 cases of young people with hyperthyroidism and had poor effect after the treatment of antithyroid drugs from January 2000 to January 2007 in our hospital were underwent surgery, and the data 2-5 years after operation were recorded. Results: The efficacy of 96 cases was satisfactory, they had small scars and less complications. Conclusion: Improved small-incision surgery is a safe, effective method for treating young people with primary hyperthyroidism, it can achieve the aim rapidly, and the incision is beautiful and can be extensively used in clinic. [Key word] Hyperthyroidism; Small incision; Surgery 甲状腺功能亢进(Graves病)简称甲亢,分为原发性甲亢、继发性甲亢和高功能腺瘤,其中以原发性甲亢较为常见,临床上占85%～90%,后两者较少见,我市面临沿海的粤西地区,原发性甲亢更为常见与多发。我院2001年1月～2007年1月对96例青少年甲亢行小切口外科手术治疗,取得较好疗效,现分析如下: 1 资料与方法 1.1 一般资料 本组96例,男23例,女73例;年龄最小12岁,最大18岁,平均16.1岁;病程1～5年;甲状腺Ⅱ度肿大81例,Ⅲ度肿大15例。合并甲亢性心脏病10例,突眼70例。根据临床症状、体征及辅助检查,96例完全符合《实用内科学》Graves病[1]的诊断标准。 1.2 手术指征 以下情况均可考虑手术:①11岁以上及中度以上小儿甲亢保守治疗无效或停药复发者;②甲状腺Ⅱ度肿大以上者或出现并发症者;③服用抗甲状腺药物后出现明显药物反应者;④因学习、工作原因无法长期服药者[2];⑤继发性甲亢和高功能腺瘤。 1.3 术前准备 术前本组病例均已就诊并服药(他巴唑、丙基硫氧嘧啶)2个月～5年不等,入院后即停用他巴唑、丙基硫氧嘧啶,给予改良卢戈液口服法,每天3次,从每次3滴开始;逐日每次2滴递增,至每次15滴为止,维持剂