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[甲状腺罕见解剖变异与异常的外科治疗]

[Surgical treatment of rare anatomic variations and anomalies of the thyroid gland].

作者信息

Ignjatović M, Petrović M, Stanić V, Cerović S, Ilić S, Jović N

机构信息

Klinika za opstu i vaskularnuh hirurgiju VMA, Beograd.

出版信息

Acta Chir Iugosl. 2000;47(1-2):107-12.

Abstract

Choristoma and thyroid gland malpositions are embryonal disorders. The aim of this article is ten years analysis of their diagnostic and operative treatment. In 1425 thyroidectomies we have found: one lingual, intratracheal, intracardial thyroid and ovarial struma; six separated intrathoracic goitre and 10 mostly intrathoracaly (80%) situated goitre; 1.4% out of all. Correct preoperative diagnosis we have in lingual thyroid, two intrathoracal thyroid and in all mostly intrathoracal thyroids, and in others after histopathological examination. Operative approach was: collar incision with medial sternotomy in nine, collar incision with lateral thoracotomy in three, right thoracotomy in two, and only collar incision in one. There were two operative complications, one recurrent nerve lesion and one mediastinal haematoma. There was no hypocalcaemia and mortality. Thyroid gland anomalies are very rare and associated with lot of problems in diagnostic and treatment. In specialised institutions frequency of operative complications is the same like in routine thyroid gland surgery.

摘要

迷离瘤和甲状腺异位是胚胎发育紊乱疾病。本文旨在对其诊断及手术治疗进行十年分析。在1425例甲状腺切除术中,我们发现:1例舌甲状腺、气管内甲状腺、心内甲状腺及卵巢甲状腺肿;6例孤立性胸内甲状腺肿,10例大多位于胸内(80%)的甲状腺肿,占总数的1.4%。对于舌甲状腺、2例胸内甲状腺及所有大多位于胸内的甲状腺,我们在术前做出了正确诊断,其他病例则是在组织病理学检查后确诊。手术方式为:9例行颈部切口加胸骨正中劈开术,3例行颈部切口加胸廓切开术,2例行右胸廓切开术,1例仅行颈部切口。有2例手术并发症,1例喉返神经损伤和1例纵隔血肿。未发生低钙血症及死亡病例。甲状腺异常非常罕见,在诊断和治疗方面存在诸多问题。在专业机构中,手术并发症的发生率与常规甲状腺手术相同。

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