Melliĕre D, Scattolini G, Germain V, Salvat A
Nouv Presse Med. 1980;9(31):2121-4.
Of 300 patients who underwent subtotal thyroidectomy, 204 had Graves' disease, 52 solitary toxic goiter and 39 multinodular toxic goiter. Cardiotoxicity was present in 40 cases. Immediate post-operative complications could be avoided by the use of propranolol, neuroleptanalgesia and, in a few very severe cases, hypothermia. Long term results were satisfactory, even after surgery for diffuse hyperthyroidism. Relapses occurred in only 2%, and permanent hypothyroidsm developed within 3 years in only 18% of patients with Graves' disease, this being due to the preservation of 6 grams of thyroid tissue systematically measured by comparative double-weighing. The authors insist on the value of this technique, guess evaluation being unreliable. Cardiotoxicity did not increase post-operative complications, nor the risk of permanent hypothyroidism. The good results obtained should encourage wider surgical indications for the treatment of Graves' disease, solitary toxic goiter or multinodular toxic goiter.
在接受甲状腺次全切除术的300例患者中，204例患有格雷夫斯病，52例为单发性毒性甲状腺肿，39例为结节性毒性甲状腺肿。40例出现心脏毒性。使用普萘洛尔、神经安定镇痛术，以及在少数非常严重的病例中采用低温疗法，可避免术后即刻并发症。即使是弥漫性甲状腺功能亢进症患者术后的长期效果也令人满意。复发率仅为2%，在格雷夫斯病患者中，仅18%在3年内出现永久性甲状腺功能减退，这是由于通过对比复秤系统测量保留了6克甲状腺组织。作者强调了这项技术的价值，认为猜测评估不可靠。心脏毒性既未增加术后并发症，也未增加永久性甲状腺功能减退的风险。所取得的良好结果应促使更广泛地采用手术治疗格雷夫斯病、单发性毒性甲状腺肿或结节性毒性甲状腺肿。
