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Hyperthyroidism improved efficacy of surgical methods of comprehensive evaluation

Analysis: Baocheng, Zhao Lichen, left east Key words hyperthyroidism; thyroid surgery; modified surgical methods; efficacy evaluation 0 Introduction mostly occurred in young women with hyperthyroidism,[link widoczny dla zalogowanych], with the the improvement of surgical skills and methods of improvement, the traditional surgical subtotal thyroidectomy complications have diminished, but there is still some incidence [1-2]. to address the normal tissue injury, less complications and good appearance and so on, we introduce the concept of minimally invasive, and surgical methods of hyperthyroidism improved, integrated satisfactory effect, are reported as follows. 1 Objects and Methods 2007  03/2008  03 at the Ben hospital's 141 patients with hyperthyroidism surgery (male 43, female 9 Cool

,[link widoczny dla zalogowanych], age (39.2 ± 15.6) years. course of 3 mo ~ 7 a. of which 7 cases of thyroid enlargement grade Ⅰ, Ⅱ degree of swelling of 99 patients, Ⅲ degree enlargement of 35 cases; about 119 cases of leaf symmetry enlargement. preoperative mild hyperthyroidism in 16 cases, 64 cases of moderate hyperthyroidism, 41 patients with severe hyperthyroidism. Preoperative complete blood, urine, then conventional, ECG,[link widoczny dla zalogowanych], respiratory is the lateral view and the clotting mechanism of checks. consecutive 3 d detect basal metabolic rate, thyroid function to understand the conditions necessary for T3, T4 inspection. They were randomly divided into the modified group (n = 65) and the control group (n = 76). Improved surgical group were treated with bilateral subtotal thyroidectomy surgery [2]. using local anesthesia or cervical plexus anesthesia, take sternal notch on 1.5 ~ 2.5 cm office for 4 ~ 6 cm long horizontal curved incision, as in the superficial cervical fascia loose tissue under the flap to the thyroid cartilage notch on the plane, the bottom seam is not free, open neck white line, do not cut off the neck muscles, the trachea above the front fascia off Opening the thyroid isthmus to the left right side retractor, with the index finger inserted into the posterolateral gland to gland slightly from top to control bleeding glands, thyroid Filed under very close between the true and false capsule gland clamp, cut, ligation of the inferior thyroid pole vessels and the thyroid vein branches in order to fully reveal the thyroid gland in the lower pole, upper pole of thyroid exploration in For removal of the thyroid resection line of the lower pole, so that the upper pole of glandular tissue retained approximately 1 cm × 1 cm × 1 cm size [3]. treated with thyroid nest \Chemical Handling: The SPSS10.0 statistical package, data x ± s, said non-paired t test, count data were analyzed by chi-square test. P <0.05 as statistically significant difference. 2 The results showed that the two groups in gender, age difference was not significant. operative time and blood loss: Improved surgical group (90.0 ± 10.1) min, (150.0 ± 17.2) mL; the control group (102.0 ± 12.5) min, (210.0 ± 21.5) mL. postoperative complications and patient satisfaction: The modified surgical patients postoperative recurrent laryngeal nerve injury in 1 case, consider anesthesia induced, 2 wk recovery, wound healing all Ⅰ, surgery After 7 to 9 (average Cool

d discharge, patient satisfaction, 95%; control group, postoperative hoarseness in 2 cases, 1 case of thyroid storm, were treated and were relieved all Ⅰ wound healing, after 10 ~ 12 ( average 10) d discharge, patient satisfaction, 88%. between two groups, the difference was statistically significant (P 0.05). ; 3 to discuss the existence of hyperthyroidism surgical incision of traditional large, poor postoperative appearance, and intraoperative and postoperative complications relatively more problems [4-5]. We will be improved with subtotal thyroidectomy compared to traditional surgical procedures, has the following advantages: ① simplify surgical procedures, do not cut off the neck muscles, reduce operating; ② subcutaneous separation surgery conducted in the loose tissue,[link widoczny dla zalogowanych], wound healing, scar is not obvious; ③ surgery reserved the most blood vessels, and vascular treatments very close to the gland, so that the residual gland and adjacent gland blood supply, and to prevent the recurrent laryngeal nerve and parathyroid injury; ④ reservations about 1 cm × 1 cm × 1 cm the size of most glandular tissue, may increase or decrease based on age appropriate, so that resection can be a good master,[link widoczny dla zalogowanych], to avoid the recurrence of postoperative hypothyroidism, or hyperthyroidism; ⑤ other drainage, thyroid surgery, incision below the sternal notch from the leads, reduce the chances of infection; ⑥ shorter hospital stays, increase patient satisfaction, reduce suffering and economic burden of patients. In summary, the combined effect of improved operation of high satisfaction is worthy. 【Reference】 [1] Wu Wensheng, Cheng Tak-chuen, Zhang Yi. thyroidectomy Clinical application of improved technologies [J]. Medical information (of VEGF), 2007, 20 (10) :943-944. [2] Yuji Chun. thyroid surgical techniques [J]. sinus surgery, 2007,14 (6) :338-340. [3] TANG Pingzhang. emphasis on complications and prevention of thyroid surgery [J]. Chinese Journal of Otology Surgery, 2007,14 (6) :321-324.
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