Palestini Nicola, Grivon Manuela, Durando Riccardo, Freddi Milena, Odasso Chiara, Robecchi Antonio
General Surgery I Unit, Department of Medical and Surgical Sciences, University of Turin, Turin, Italy.
Ann Ital Chir. 2007 Sep-Oct;78(5):405-12.
To retrospectively investigate the patients' views of surgical treatment of Graves' hyperthyroidism.
One hundred two patients were included in the study and submitted to extensive subtotal thyroidectomy or total thyroidectomy between 1993-2003. Data were acquired from the responses to a questionnaire, that was completed by 83 patients.
Before the operation the working/studying ability and the social/emotional relations were impaired in 20% and 22% of cases. Preoperative information was adequate for 84% of patients. The perception of the hospital efficiency was favourable in 89% of cases, and the interpersonal relations with clinicians and nurses were very positive for 96% of patients. After the operation, all patients were hypothyroid on levothyroxine (l-T4); unexpected problems with l-T4 therapy occurred in 6% of cases. Voice changes or neck discomfort were reported by 29% and 8% of patients. The aesthetic appearance of the scar was very satisfactory for 70% of patients, but 11% were unsatisfied. The working/studying ability and the social/emotional relations improved in 63% and 59% of cases. Eye symptoms improved in 71% of the patients with endocrine ophthalmopathy, but got worse in 60%. The quality of life, expressed with a 0 to 10 scale, improved from a mean preoperative score of 4.7 to a mean score of 7.9 (P = 0.000). Only 5% of patients expressed hesitation to recommend surgery to a friend with similar disease.
Surgery is an effective therapy for selected cases of Graves' disease and meets the expectations of the majority of patients. Nevertheless some possible factors for dissatisfaction are pointed out.
回顾性调查患者对格雷夫斯甲亢手术治疗的看法。
102例患者纳入本研究，于1993年至2003年间接受广泛甲状腺次全切除术或甲状腺全切除术。数据来自83例患者填写的问卷回复。
术前，20%的病例工作/学习能力受损，22%的病例社会/情感关系受损。84%的患者术前信息充足。89%的病例对医院效率评价良好，96%的患者与医护人员的人际关系非常积极。术后，所有患者服用左甲状腺素（l-T4）后出现甲状腺功能减退；6%的病例出现l-T4治疗意外问题。29%的患者报告有声音改变，8%的患者报告有颈部不适。70%的患者对瘢痕美观非常满意，但11%的患者不满意。63%的病例工作/学习能力改善，59%的病例社会/情感关系改善。71%的内分泌性眼病患者眼部症状改善，但60%的患者症状恶化。生活质量用0至10分表示，术前平均得分为4.7分，术后平均得分为7.9分（P = 0.000）。只有5%的患者表示犹豫是否会向患有类似疾病的朋友推荐手术。
手术是格雷夫斯病特定病例的有效治疗方法，符合大多数患者的期望。然而，指出了一些可能导致不满的因素。
