甲状腺全切术及甲状腺次全切术在甲状腺多发结节治疗中的效果观察
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摘要
目的:观察并比较甲状腺全切术、甲状腺次全切术治疗甲状腺多发结节的临床效果。方法:选择2013年7月—2017年1月收治的甲状腺多发性结节患者122例为研究对象,将其随机分为观察组和对照组,每组61例。观察组采用甲状腺次全切术治疗,对照组采用甲状腺全切术治疗。比较两组患者手术时间、术中出血量、术后住院时间、治疗有效率、术后并发症发生情况、复发情况以及术前术后甲状腺功能指标变化情况。结果:观察组手术时间、术中出血量明显低于对照组,术后6个月复发率明显高于对照组(P<0.05)。两组患者术后住院时间、治疗总有效率、并发症发生率比较差异无统计学意义(P>0.05)。术前两组患者血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)比较差异无统计学意义(P>0.05),术后观察组FT3、FT4水平明显高于对照组,TSH水平明显低于对照组,差异有统计学意义(P<0.05)。结论:甲状腺全切术虽然创伤较大,但治疗更彻底,术后不易复发。
Objective: To observe and compare the clinical effects of total thyroidectomy and subtotal thyroidectomy in the treatment of multiple thyroid nodules. Methods: In hospital in July 2013 to January 2017 benign thyroid nodules in 122 patients as the research object,randomly divided into observation group and control group,61 cases in each group,the observation group with subtotal resection,the control group using total thyroidectomy treatment,to compare operative time,the amount of bleeding,postoperative hospitalization time and other indicators and the efficiency of treatment,complications and recurrence after operation,marked changes in thyroid function before and after surgery in two groups of patients. Results: The operation time,blood loss in observation group was significantly lower than the control group. The recurrence rate at 6 months after operation was significantly higher than that in the control group(P < 0. 05). There was no significant difference in postoperative hospital stay,total effective rate and complication rate between the two groups(P > 0. 05). There was no significant difference in serum free triiodothyronine(FT3),free thyroxine(FT4) and thyrotropin(TSH) between the two groups before operation(P >0. 05),The levels of FT3 and FT4 in the observation group were significantly higher than those in the control group,and the TSH levels in the control group were significantly lower than those in the control group(P < 0. 05). Conclusion: although total thyroidectomy is more traumatic,the treatment is more complete,and it is difficult to recur after operation.
Objective: To observe and compare the clinical effects of total thyroidectomy and subtotal thyroidectomy in the treatment of multiple thyroid nodules. Methods: In hospital in July 2013 to January 2017 benign thyroid nodules in 122 patients as the research object,randomly divided into observation group and control group,61 cases in each group,the observation group with subtotal resection,the control group using total thyroidectomy treatment,to compare operative time,the amount of bleeding,postoperative hospitalization time and other indicators and the efficiency of treatment,complications and recurrence after operation,marked changes in thyroid function before and after surgery in two groups of patients. Results: The operation time,blood loss in observation group was significantly lower than the control group. The recurrence rate at 6 months after operation was significantly higher than that in the control group(P < 0. 05). There was no significant difference in postoperative hospital stay,total effective rate and complication rate between the two groups(P > 0. 05). There was no significant difference in serum free triiodothyronine(FT3),free thyroxine(FT4) and thyrotropin(TSH) between the two groups before operation(P >0. 05),The levels of FT3 and FT4 in the observation group were significantly higher than those in the control group,and the TSH levels in the control group were significantly lower than those in the control group(P < 0. 05). Conclusion: although total thyroidectomy is more traumatic,the treatment is more complete,and it is difficult to recur after operation.
引文
[1]莫奇霏,郭永学,李嘉兴.两种甲状腺切除术治疗甲状腺结节的临床疗效观察[J].中国医药科学,2015,5(18):102-104.
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[5]张敏毅.单侧甲状腺结节手术治疗的临床效果分析[J].医药卫生,2016,2(9):254.
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[7]吴益群.甲状腺结节手术适应证和术式选择[J].临床合理用药,2016,9(11):110-111.
[8]刘辉斌.甲状腺腺叶切除术和甲状腺次全切除术治疗甲状腺结节的优劣差异[J].中国当代医药,2016,23(5):47-49.
[9]侯化森,傅跃权,靳维娜,等.甲状腺腺叶全切术与次全切除术治疗甲状腺结节的临床疗效及对患者甲状腺功能的影响[J].中国基层医药,2016,23(11):1660-1663.
[2]梁法汤.两种甲状腺切除术治疗甲状腺结节37例的临床观察[J].中外医学研究,2013,11(31):184-185.
[3]温泉江.甲状腺全切术与甲状腺次全切术治疗双侧结节性甲状腺肿的临床疗效比较[J].中国继续医学教育,2016,8(5):121-122.
[4]冯云龙.甲状腺次全切除术治疗双侧结节性甲状腺肿75例效果分析[J].中国民康医学,2014,26(15):44-45.
[5]张敏毅.单侧甲状腺结节手术治疗的临床效果分析[J].医药卫生,2016,2(9):254.
[6]江道振.结合甲状腺结节诊治指南谈甲状腺结节的评估和手术指证[J].上海医药,2013,34(24):10-12.
[7]吴益群.甲状腺结节手术适应证和术式选择[J].临床合理用药,2016,9(11):110-111.
[8]刘辉斌.甲状腺腺叶切除术和甲状腺次全切除术治疗甲状腺结节的优劣差异[J].中国当代医药,2016,23(5):47-49.
[9]侯化森,傅跃权,靳维娜,等.甲状腺腺叶全切术与次全切除术治疗甲状腺结节的临床疗效及对患者甲状腺功能的影响[J].中国基层医药,2016,23(11):1660-1663.