Postma Duncan S, Becker Marie O, Roberts Adrian, Gilleon Spencer, Soto Joseph
Department of Clinical Sciences, Florida State University College of Medicine, 1405 Centerville Rd., Suite 5400, Tallahassee, Florida 32312, USA.
Ear Nose Throat J. 2009 May;88(5):E30.
The objective of this study was to determine the characteristics and surgical outcomes of 100 consecutive cases of thyroidectomy (in 98 patients) at a community hospital from October 2005 to mid-November 2006. Preoperative laryngoscopy was performed in 94% of patients and postoperative laryngoscopy in 100%. Patients' thyroid nodules had been found incidentally in 28% of cases. The two most common indications for surgery were results of fine-needle aspiration biopsy (FNA) in 55% and size of the thyroid in 22% of cases. Of the 98 patients, 79 (81%) had benign diagnoses, 7 (7%) had microcarcinomas, and 12 (12%) had well-differentiated thyroid cancer. Overall, 5 patients (5%) had temporary recurrent laryngeal nerve paralysis, but this occurred in only 1 (1%) patient in the group with smaller lesions, a statistically significant difference (p< 0.02); none had permanent paralysis. Of 36 patients at risk for hypocalcemia, 3 (8%) and 1 (3%) had temporary and long-term hypocalcemia, respectively. There was no incidence of significant hemorrhage. FNA results were very accurate. We show that thyroidectomy can be performed with minimal laryngeal nerve paralysis or other complications. Larger lesions had significantly higher rates of temporary laryngeal nerve paralysis.
本研究的目的是确定2005年10月至2006年11月中旬在一家社区医院连续进行的100例甲状腺切除术（98例患者）的特征和手术结果。94%的患者进行了术前喉镜检查，100%的患者进行了术后喉镜检查。28%的病例中患者的甲状腺结节是偶然发现的。手术的两个最常见指征是：55%的病例为细针穿刺活检（FNA）结果，22%的病例为甲状腺大小。98例患者中，79例（81%）诊断为良性，7例（7%）为微癌，12例（12%）为高分化甲状腺癌。总体而言，5例患者（5%）出现暂时性喉返神经麻痹，但在病变较小的组中仅1例（1%）出现，差异有统计学意义（p<0.02）；无永久性麻痹。36例有低钙血症风险的患者中，分别有3例（8%）和1例（3%）出现暂时性和长期低钙血症。无明显出血事件发生。FNA结果非常准确。我们表明，甲状腺切除术可以在喉返神经麻痹或其他并发症极少的情况下进行。较大病变的暂时性喉返神经麻痹发生率显著更高。
