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中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (05) : 526 -529. doi: 10.3877/cma.j.issn.1674-3946.2020.05.026

所属专题: 文献

论著

Dunhill术、全切术与次全切术治疗双侧结节性甲状腺肿的临床比较
朱智1, 程腾1,(), 董鸿1, 张磐石1, 郑伟红1   
  1. 1. 430030 华中科技大学同济医学院附属同济医院
  • 收稿日期:2020-03-04 出版日期:2020-10-26
  • 通信作者: 程腾

Clinical comparison of Dunhill operation, total resection and subtotal resection for bilateral nodular goiter

Zhi Zhu1, Teng Chen1,(), Hong Dong1, Panshi Zhang1, Weihong Zheng1   

  1. 1. Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology 430030
  • Received:2020-03-04 Published:2020-10-26
  • Corresponding author: Teng Chen
  • About author:
    Correspondence author: Cheng Teng, Email:
引用本文:

朱智, 程腾, 董鸿, 张磐石, 郑伟红. Dunhill术、全切术与次全切术治疗双侧结节性甲状腺肿的临床比较[J/OL]. 中华普外科手术学杂志(电子版), 2020, 14(05): 526-529.

Zhi Zhu, Teng Chen, Hong Dong, Panshi Zhang, Weihong Zheng. Clinical comparison of Dunhill operation, total resection and subtotal resection for bilateral nodular goiter[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(05): 526-529.

目的

比较Dunhill术、全切术与次全切术治疗双侧结节性甲状腺肿的临床价值。

方法

回顾性分析2016年1月至2019年6月收治的325例双侧结节性甲状腺肿患者的病例资料,根据术式不同,将全切术治疗的患者纳入全切组(102例),将次全切术治疗的患者纳入次全切组(108例),将Dunhill术治疗的患者纳入Dunhill组(115例)。采用SPSS 25.0软件包校对全组数据,手术相关指标等计量资料以(±s)描述,多组间比较采用方差分析;临床疗效、并发症、复发情况等计数资料用频数(n)、率(%)描述,行χ2检验,P<0.05为差异有统计学意义。

结果

三组治疗总有效率及术后6个月复发率比较,差异无统计学意义(P>0.05);与全切组相比,Dunhill组手术时间较长、术中出血量较多、住院时间较短,Dunhill组和次全切组术后并发症总发生率较高,Dunhill组手术时间比次全切组短,差异有统计学意义(P<0.05)。

结论

相比甲状腺次全切术与Dunhill术,甲状腺全切术在治疗双侧结节性甲状腺肿时复发率及术后并发症发生率较低,但对患者甲状腺功能影响较大。而Dunhill术可有效兼顾治疗有效性及安全性,在实际临床工作中,可结合患者需要而谨慎选择。

Objective

To compare the clinical value of Dunhill operation, total resection and subtotal resection for bilateral nodular goiter.

Methods

The data of 325 patients with bilateral nodular goiter admitted from January 2016 to June 2019 were retrospectively analyzed. According to the different surgical methods, the patients treated with total excision were included in the total excision group (102 cases), the patients treated with subtotal resection were included in the subtotal resection group (108 cases), and patients treated with Dunhill operation were included in the Dunhill group (115 cases). SPSS 25.0 software package was used for analyze. The measurement data such as surgery-related indicators were described as (±s), and compared by analysis of variance; frequency of clinical data such as clinical efficacy, complications, and recurrence (n) were described as the rate (%), and compared with χ2 test, and P<0.05 was considered statistically significant.

Results

There was no significant difference in the total effective rate of treatment and the recurrence rate at 6 months after operation among the three groups (P>0.05). Compared with the total resection group, the Dunhill group had longer operation time, more intraoperative blood loss, and shorter hospital stay. the total incidence of postoperative complications was higher in the Dunhill and subtotal group. Compared with the subtotal resection group, the operation time in the Dunhill group was shorter (P<0.05).

Conclusion

Compared with subtotal thyroidectomy and Dunhill operation, total thyroidectomy has the advantage of lower recurrence and lower postoperative complications, but has a greater influence on patients with thyroid function. The Dunhill technique can effectively balance the effectiveness and safety of treatment. In clinical work, it can be carefully selected in accordance with the needs of patients.

表1 325例双侧结节性甲状腺肿患者不同术式三组基线资料比较[(±s),例]
表2 325例双侧结节性甲状腺肿患者不同术式三组临床疗效比较(例)
表3 325例双侧结节性甲状腺肿患者不同术式三组手术相关指标比较(±s)
表4 325例双侧结节性甲状腺肿患者不同术式三组并发症情况比较(例)
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