文档介绍：胸内甲状腺肿的外科治疗
作者:范利民陈勇姚曹克坚陈岗
【摘要】目的回顾总结胸内甲状腺肿临床特征及外科治疗,提供临床经验。方法本组78例患者中,男30例,女48例,平均年龄59岁。病灶颈胸相连者68例,完全位于胸内10例。主要症状:气管、食管压迫症状占大多数;4例有甲亢症状,无症状10例,16例既往有甲状腺手术史。全组均行手术治疗。切口选择颈低位领式切口50例,低位领式切口加正中劈开胸骨12例,正中劈开胸骨8例,右后外侧切口6例,左后外切口加领式切口2例。结果全组无手术死亡,喉返神经损伤3例,术后出现气管软化2例。病理:腺瘤48例,异位甲状腺10例,结节状甲状腺肿5例,甲状腺钙化结节2例,甲状腺局部癌变6例,甲状腺髓样癌4例,转移性甲状腺癌3例。结论及时的手术是治疗胸内甲状腺肿唯一安全有效的方法。
关键词甲状腺肿胸内外科手术
Surgical treatment of intrathoracic goiter:clinical analysis of78cases
【Abstract】 Objective To discuss clinical character and surgical management of78intrathoracic goiter cases in this retrospective 78patients with intrathoracic goiter were operated in Shanghai chest majority of the goiter were cervicothoracic
(n=68,87%),and the others pletely located intrathoracic(n=10,13%).Of these patients,13%(n=10)were symptom-free,in the others the clinical characters were domi-nated by pressure %of patients(n=16)were operated previously on cervical %(n=4)of the patients had hyperthyroid majority(n=50)of cervicothoracic goiter could be removed through a cervical access,in the others an additional sternotomy(n=12),or anterior thoracotomy(n=8)were -sults Recurrent laryngeal nerve injurywas in3patients(4%).Tracheomalacia developed in2patients(3%).62%(n=48)of the lesion was proved to be adenoma goiter by histology and10were ectopic On