Melliere D, Etienne G, Becquemin J P
Division of Vascular and Endocrine Surgery, Henri Mondor Hospital, Paris XII University, Creteil, France.
Am J Surg. 1988 Mar;155(3):395-9. doi: 10.1016/s0002-9610(88)80098-9.
Five hundred patients with hyperthyroidism underwent operation between 1970 and 1984. Sixty-nine percent had Graves' disease, 19 percent had toxic thyroid adenoma, and 12 percent had multinodular toxic goiter. Good results were achieved in the 275 patients most recently treated. These results may be attributed to the following: good personal contact between the surgeon and the patient at the first meeting, 1 month of preoperative management with carbimazole and propranolol without interruption of work, operation adapted to the type of goiter, and treatment of postoperative tachycardia by propranolol. The mean duration of hospital stay was 5 days. Sequelae were rare. In the patients with Graves' disease, results at 2 years were as follows: 74 percent of operated patients were euthyroid, 23 percent required substitutive treatment, and surgical treatment failed or early relapse occurred in 3 percent. There were no recurrences after operation in patients with solitary or multinodular toxic goiter, but 30 percent of the former and 98 percent of the latter had to be treated with L-thyroxine. Seventy-two percent of the patients who presented with atrial fibrillation had return of normal cardiac rhythm after operation.
1970年至1984年间，500例甲状腺功能亢进患者接受了手术治疗。其中69%患有格雷夫斯病，19%患有毒性甲状腺腺瘤，12%患有结节性毒性甲状腺肿。最近接受治疗的275例患者取得了良好的效果。这些结果可能归因于以下几点：外科医生与患者初次见面时良好的个人沟通；术前使用卡比马唑和普萘洛尔进行1个月的治疗且不影响工作；根据甲状腺肿类型进行手术；术后使用普萘洛尔治疗心动过速。平均住院时间为5天。后遗症很少见。格雷夫斯病患者术后2年的结果如下：74%的手术患者甲状腺功能正常，23%需要替代治疗，3%的患者手术治疗失败或早期复发。孤立性或结节性毒性甲状腺肿患者术后无复发，但前者中有30%、后者中有98%需要接受左甲状腺素治疗。出现房颤的患者中，72%术后心律恢复正常。
