Thomusch O, Sekulla C, Ukkat J, Gastinger L, Lippert H, Dralle H
Klinik für Allgemeinchirurgie, Martin-Luther-Universität Halle-Wittenberg.
Zentralbl Chir. 2001 Sep;126(9):664-71. doi: 10.1055/s-2001-18249.
A quality control study was undertaken on 7,265 patients with benign goitre and 352 patients with malignant goitre who were surgically treated between 1.1.98 and 31.12.98. 3 hospital groups were defined according to surgical workload: Group 1: < 50 operations/yr; Group 2: 50-150 operations/yr; Group 3: > 150 operations/yr. The temporary rate of recurrent laryngeal nerve (RLN) palsies for benign goitre was 3.9% and the permanent 1.1%. For malignant goitre the rates were 12.8% and 6.8% respectively. The rate of temporary (p < 0.040) and permanent (0.003) palsies after surgery for benign goitre was lower in group 3 compared to group 1 and 2. There were too few cases for statistical analysis of the malignant goitres. After benign goitre surgery a transient hypocalcaemia rate of 6.3% and a permanent of 1.1% were observed. For malignant goitre the incidence was 23.8% and 7.1%, respectively. A significantly increased rate of permanent hypocalcaemia (p < 0.003) was demonstrated in group 3 after surgery for multinodular goitre. Centres in group 3 made more extended (smaller thyroid remnants) resections (p < 0.01) with the equivalent rate of general complications. The average inpatient stay for malignant goitres was 13.1 days and for benign goitres 8.7 days. On average, patients with bilateral resections for benign goitre stayed 0.4 days longer in hospital than those with unilateral procedures. Prophylactic antibiotics were administered to 2.1% of patients and 94.6% received thrombosis prophylaxis.
对1998年1月1日至1998年12月31日期间接受手术治疗的7265例良性甲状腺肿患者和352例恶性甲状腺肿患者进行了一项质量控制研究。根据手术工作量将3个医院组进行了定义：第1组：每年手术量＜50例；第2组：每年手术量50 - 150例；第3组：每年手术量＞150例。良性甲状腺肿喉返神经（RLN）麻痹的暂时性发生率为3.9%，永久性发生率为1.1%。恶性甲状腺肿的发生率分别为12.8%和6.8%。与第1组和第2组相比，第3组良性甲状腺肿手术后暂时性（p＜0.040）和永久性（p＜0.003）麻痹的发生率较低。恶性甲状腺肿的病例数过少，无法进行统计分析。良性甲状腺肿手术后，观察到暂时性低钙血症发生率为6.3%，永久性发生率为1.1%。恶性甲状腺肿的发生率分别为23.8%和7.1%。第3组多结节性甲状腺肿手术后永久性低钙血症发生率显著升高（p＜0.003）。第3组的中心进行了更广泛（甲状腺残余组织更小）的切除（p＜0.01），总体并发症发生率相当。恶性甲状腺肿患者的平均住院时间为13.1天，良性甲状腺肿患者为8.7天。平均而言，良性甲状腺肿双侧切除患者的住院时间比单侧手术患者长0.4天。2.1%的患者使用了预防性抗生素，94.6%的患者接受了血栓预防。
