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目的:探讨甲状腺全切术的安全性,使其成为治疗某些甲状腺良性或恶性病变的主要方法。方法:回顾性分析了我科近5年来施行的351例甲状腺全切术,手术前后均行电子喉镜检查判断喉返神经的功能。术前及术后当日、3d和1周分别化验血清钙,并记录患者的症状。结果:术后1周内无症状低血钙发生率为47.01%,症状轻微者为21.37%,症状较重者为15.67%,永久性甲状旁腺机能减退且需长期补钙治疗者为0.85%;无双侧喉返神经损伤,术后暂时性喉返神经麻痹发生率为1.42%,永久性声带麻痹者为0.56%。结论:甲状腺全切术是安全可行的。术中暴露喉返神经、保护甲状旁腺及其血供,是防止术后并发症的关键。
Objective: To investigate the safety of total thyroidectomy, making it the treatment of some benign or malignant thyroid lesions the main method. Methods: 351 cases of total thyroidectomy performed in our department in recent 5 years were retrospectively analyzed. The function of the recurrent laryngeal nerve was evaluated by electronic laryngoscopy before and after operation. Preoperative and postoperative day, 3d and 1 week were tested serum calcium, and record the patient’s symptoms. Results: Within one week after operation, the incidence of asymptomatic hypocalcemia was 47.01%, mild symptoms were 21.37%, severe symptoms were 15.67%, permanent hypoparathyroidism was 0.85% The incidence of bilateral recurrent laryngeal nerve injury was 1.42% for postoperative laryngeal nerve paralysis and 0.56% for permanent vocal cord paralysis. Conclusion: Total thyroidectomy is safe and feasible. Intraoperative exposure to the recurrent laryngeal nerve to protect the parathyroid and its blood supply is the key to preventing postoperative complications.