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[甲状腺疾病的急诊手术及术后并发症]

[Urgent operations for diseases of the thyroid gland and postoperative complications].

作者信息

Romanchishen A F, Bagaturiia G O, Bogatikov A A, Kim I Iu, Vabalaĭte K V

出版信息

Vestn Khir Im I I Grek. 2012;171(2):34-40.

Abstract

Anasplastic carcinoma of the thyroid gland (243 cases), polinodous goiter of cervical retrosternal localization (25 cases), acute purulent strumitis or thyroiditis (9 cases) induced disturbance of aero-digestive organs of the neck and resulted in the necessary urgent surgical care. The most dangerous complications after 23777 operations on the TG requiring repeated surgical intervention were bilateral lesion of the recurrent nerves (1% of observations), hemorrhages in the TG bed (0.38% of observations). Timely surgical treatment as well as exact knowledge of the neck anatomy, visual control of the recurrent laryngeal nerves, cover of the nerves and lessening the TG bed volume with a part of the parietal leaf of the 4th fascia of the neck in each thyroid operation considerably decreased the danger of asphyxia and the appearance of life threatening complications at the early postoperative period.

摘要

甲状腺未分化癌(243例)、颈胸骨后局限性多结节性甲状腺肿(25例)、急性化脓性甲状腺炎(9例)引起颈部空气消化道器官功能紊乱,因此需要进行紧急手术治疗。在23777例甲状腺手术中,需要再次手术干预的最危险并发症是双侧喉返神经损伤(占观察病例的1%)、甲状腺床出血(占观察病例的0.38%)。及时的手术治疗以及对颈部解剖结构的确切了解、直视下对喉返神经的控制、神经的覆盖以及在每次甲状腺手术中用颈部第4筋膜的部分壁层叶减少甲状腺床体积,可大大降低术后早期窒息的危险和危及生命并发症的出现。

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