Observation of the effect of Dunhill surgery on bilateral nodular goiter and its effect on thyroid function

doi:10.3877/cma.j.issn.1674-3946.2020.01.018

Abstract

Abstract:

Objective

To investigate the effect of Dunhill operation on bilateral nodular goiter and its effect on thyroid function.

Methods

A total of 80 patients with bilateral nodular thyroid were selected from January 2017 to January 2018, according to the numerical table method, it was randomly divided into Dunhill group and total tangent group. Total thyroidectomy was performed in the total thyroidectomy group, Unilateral total thyroidectomy plus contralateral subtotal thyroidectomy (Dunhill) was performed in the Dunhill group. SPSS18.0 statistical software was used for data analysis, Perioperative indicators、blood calcium and PTH numerical (±s), Independent T test was used to compare. The cure rate and recurrence rate were compared by χ² test, P<0.05 was statistically significant.

Results

The results of Intraoperative blood loss、analgesic dosage、duration of surgery、length of hospitalization and incidence of postoperative complications were all lower in the Dunhill group than those in the total resection group (P<0.05); The clinical efficacy of Dunhill group was higher than that of total resection group (P<0.05), however, the recurrence rate (12.5%) was significantly higher than that of the total excision group (0%) (P<0.05); There was no significant difference between the two groups in the preoperative serum calcium value and PTH value (P>0.05), The serum calcium and PTH levels in the Dunhill group were better than those in the total resection group at 2 days and 6 days after surgery (P<0.05).

Conclusion

Both surgical methods are effective for bilateral nodular goiter. Dunhill has a higher recurrence rate than total thyroidectomy. However, it can effectively reduce postoperative complications, An appropriate operation method should be chosen according to patient condition.

Key words: Goiter, nodular, Thyroidectomy, Comparative effectiveness research

Qiang Zhang, Hengping Li, Xingjian Zhou, Zhen Zhou. Observation of the effect of Dunhill surgery on bilateral nodular goiter and its effect on thyroid function[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(01): 58-61.

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Figures/Tables 5

References 18

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组别	例数	术中出血量	镇痛剂用量	手术时长	住院时长
全切组	40	112.5±22.4	142.6±12.4	64.8±12.3	10.2±1.2
Dunhill组	40	58.6±16.5	86.7±10.3	54.2±10.7	8.9±1.4
t值	?	14.529	13896	12.758	11.487
P值	?	<0.05	<0.05	<0.05	<0.05

组别	例数	术中出血量	镇痛剂用量	手术时长	住院时长
全切组	40	112.5±22.4	142.6±12.4	64.8±12.3	10.2±1.2
Dunhill组	40	58.6±16.5	86.7±10.3	54.2±10.7	8.9±1.4
t值	?	14.529	13896	12.758	11.487
P值	?	<0.05	<0.05	<0.05	<0.05

组别	例数	显效	有效	无效	有效率	复发
全切组	40	17(42.5)	19(47.5)	4(10.0)	90.0%	0(0.0)
Dunhill组	40	21(52.5)	18(45.0)	1(2.5)	97.5%	5(12.5)
χ²值	/	6.824	4.974	6.397	5.648	5.249
P值	/	<0.05	<0.05	<0.05	<0.05	<0.05

组别	例数	显效	有效	无效	有效率	复发
全切组	40	17(42.5)	19(47.5)	4(10.0)	90.0%	0(0.0)
Dunhill组	40	21(52.5)	18(45.0)	1(2.5)	97.5%	5(12.5)
χ²值	/	6.824	4.974	6.397	5.648	5.249
P值	/	<0.05	<0.05	<0.05	<0.05	<0.05

组别	例数	喉返神经损伤	甲状腺功能减退	甲状旁腺损伤
全切组	40	2(5.0)	3(7.5)	4(10.0)
Dunhill组	40	1(2.5)	0(0.0)	3(7.5)
χ²值	/	4.986	6.382	5.761
P值	/	<0.05	<0.05	<0.05
组别	例数	四肢麻木、抽搐	声音嘶哑	发生率(%)
全切组	40	4(10.0)	3(7.5)	40.0
Dunhill组	40	1(2.5)	1(2.5)	15.0
χ²值	/	6.964	6.138	7.046
P值	/	<0.05	<0.05	<0.05

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