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目的探讨甲状腺全切除治疗甲状腺功能亢进症(甲亢)的可行性。方法回顾性分析9年余本院应用甲状腺全切除术治疗3 1例甲亢患者的临床资料,并与同期行传统甲状腺双侧叶次全切除的5 6例患者进行比较。结果甲状腺全切除手术组无术后出血病例,无甲亢复发病例,术后均合并甲减;而甲状腺双侧叶次全切除手术组术后出血率和甲亢复发率分别为3.6%和2 6.8%(两组比较,P值分别为P<0.0 5,P<0.0 1),术后出现甲减2 7(4 8.2%)例。两组术后均无永久性甲状旁腺功能低下并发症,喉返神经损伤发生率无明显差异(P>0.0 5)。结论甲状腺全切除术治疗甲亢效果优于次全切除术,且其并发症总发生率和复发率低于后者。
Objective To investigate the feasibility of total thyroidectomy for hyperthyroidism (hyperthyroidism). Methods The clinical data of 31 cases of hyperthyroidism treated with total thyroidectomy in our hospital for more than 9 years were retrospectively analyzed. The data were compared with 56 cases of subtotal thyroidectomy in the same period. Results There were no cases of postoperative hemorrhage and no recurrence of hyperthyroidism in the total thyroidectomy group. All patients underwent thyroidectomy combined with hypothyroidism. The recurrence rates of hemorrhage and hyperthyroidism in the thyroidectomy group were 3.6% and 26.8% respectively, (P values were P <0.0 5, P <0.0 1, respectively). A hypothyroidism (27.2%) cases occurred after operation. There were no permanent complications of hypoparathyroidism and no significant difference in the incidence of recurrent laryngeal nerve injury between the two groups (P> 0.0 5). Conclusions Total thyroidectomy is superior to subtotal resection in the treatment of hyperthyroidism, and the total complication rate and recurrence rate are lower than the latter.