甲状腺被膜内次全切除术近期并发症临床剖析.docVIP

甲状腺被膜内次全切除术近期并发症临床剖析 　　[摘要] 目的 探讨甲状腺被膜内次全切除术近期并发症的发生情况。 方法 选取2012年9月～2014年9月在广东东莞市人民医院接受治疗的甲状腺疾病患者84例。将其随机分为两组，观察组42例患者采用甲状腺被膜内次全切除术，对照组42例患者实施被膜外次全切除术。记录并比较两组患者手术时间、术中出血量、镇痛剂使用量及住院时间；比较两组患者术后7 d内甲状旁腺功能减退、低钙血症及低钙症状发生率。术后随访4周，观察比较两组患者饮水呛咳、声音嘶哑、手足抽搐或麻木、喉返神经损伤、呼吸困难或窒息感等并发症发生情况。 结果 两组患者手术时间、术中出血量、住院时间比较差异均无统计学意义（P 0.05）。术后7 d，观察组甲状旁腺功能减退（2.38%）、低钙血症（4.76%）、抽搐和惊厥低钙症状发生率（0.00%、0.00%）显著低于对照组（30.95%、40.47%、16.67%、7.14%），差异均有统计学意义（P 0.05），两组并发症总发生率比较，差异有统计学意义（P 0.05）。观察组患者中，27例接受单侧切除术，1例（3.70%）患者发生并发症；15例接受双侧切除术，4例（26.67%）患者发生并发症。对照组患者中，26例接受单侧切除术，5例（19.23%）患者发生并发症；16例患者接受双侧切除术，10例（62.50%）患者发生并发症。行单侧切除术的患者术后并发症的发生率低于行双侧切除的患者，差异有高度统计学意义（P 0.01）。 结论 甲状腺被膜内次全切除术近期并发症发生情况较少，且单侧切除术术后的情况要优于双侧切除术术后的情况。 　　[关键词] 甲状腺疾病；甲状腺被膜内次全切除术；被膜外次全切除术次全切除术；近期并发症 　　[中图分类号] R581 [文献标识码] A [文章编号] 1673-7210（2015）06（a）-0115-05 　　Clinical analysis of short-term complications of membrane subtotal thyroid resection 　　LI Libo REN Haotang CHEN Jianxin 　　The First Area of General Surgery， the Peoples Hospital of Dongguan City， Guangdong Province， Dongguan 523059， China 　　[Abstract] Objective To investigate the short-term complications of membrane subtotal thyroid resection. Methods 84 patients with thyroid diseases from September 2012 to September 2014 in the Peoples Hospital of Dongguan City were selected， and they were randomly divided into two groups， 42 patients of the observation group were given thyroid envelope subtotals excision； 42 patients of the control group were given the implementation of the outer envelope subtotals resection. Operation time， amount of bleeding during the operation， analgesic usage and hospitalization time of two groups were recorded and compared. The incidences of parathyroid function decline， hypocalcemia calcium symptoms， low calcium 7 days after operation were compared between the two groups. Patients were followed up for 4 weeks after operation， and the incidences of drinking cough， hoarseness， tetany or numbness， recurrent laryngeal nerve injury， difficulty