Service de chirurgie digestive, générale et endocrinienne, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France.
J Visc Surg. 2013 Sep;150(4):249-56. doi: 10.1016/j.jviscsurg.2013.04.003. Epub 2013 Jun 6.
The two most common early complications of thyroid surgery are hypocalcemia (20-30%) and recurrent laryngeal nerve injury (5-11%). Bilateral recurrent nerve paralysis resulting in adduction of the vocal cords is a rare life-threatening complication (occurring in less than 0.1% of cases that requires emergency management. Prevention of complications depends on careful operative technique and is enhanced for some teams by the use of specific techniques such as intraoperative neuromonitoring. Postsurgical hypocalcemia is managed by the administration of calcium plus vitamin D for at least 10 days. Recurrent laryngeal nerve paralysis recovers in most cases, and no invasive therapy should be performed for at least six months, except for emergency presentations; laryngeal surgery techniques may offer significant improvement if phonation or respiratory sequelae persist beyond six months, but the results are inconsistent. There should be a systematic strategy for detection of complications after thyroidectomy involving a multidisciplinary approach.
甲状腺手术后最常见的两种早期并发症是低钙血症（20-30%）和喉返神经损伤（5-11%）。双侧喉返神经麻痹导致声带内收是一种罕见的危及生命的并发症（发生在不到 0.1%的病例中，需要紧急处理。预防并发症取决于精细的手术技术，对于某些团队来说，通过使用特定技术（如术中神经监测）可以增强预防效果。术后低钙血症通过给予钙加维生素 D 至少 10 天来治疗。大多数情况下，喉返神经麻痹会恢复，除紧急情况外，至少在六个月内不应进行任何侵入性治疗；如果发音或呼吸后遗症持续超过六个月，喉手术技术可能会有显著改善，但结果不一致。甲状腺切除术后并发症的检测应采用多学科方法，制定系统的策略。
