胸骨后甲状腺肿的诊断与外科治疗

摘要

Objective To discuss the diagnosis and surgical treatment of substernal thyroid goiter.MethodsThirty-one cases with substernal thyroid goiter or adenoma underwent surgical treatment from June 1995 to June2006.Postoperative diagnoses were confirmed by pathology.Results The whole group of surgery are successfulwithout complications and deaths occurred.4 cases of recurrence,3 cases need long-term use thyroxine because ofhypothyroidism after the surgery.Conclusion Clinical manifestations,B-ultrasonography and CT scan areimportant methods for diagnosis of substernal thyroid goite.Complete excision is the primary treatment option.%目的 探讨胸骨后甲状腺肿的诊断要点和手术方法.方法 回顾性分析经手术切除并经病理证实为胸骨后甲状腺肿32例患者的临床资料,31例经颈部低位切口切除,1例经胸骨正中劈开切除.结果 手术均获得成功,全组无死亡病例及合并症发生.复发4例(结节性甲状腺肿),术后因甲状腺功能低下需长期服用甲状腺素者3例.结论 胸骨后甲状腺肿的诊断除根据临床症状、体征外,影像学检查是确诊的重要手段.首选治疗方法是手术切除,绝大多数患者经颈部切口可以顺利摘除,但如胸内肿块巨大或肿块迭主动脉弓以下者,应劈开胸骨或开胸切除.