陈耀智　邹卫　齐银琢

【摘要】 目的：探讨甲状腺次全切与近全切除术后早期甲状腺激素变化的临床研究。方法：选择2017年6月-2019年4月接受治疗的行甲状腺手术治疗患者120例作为对象，按照随机数字表法将患者分为对照组（n=60）和观察组（n=60）。对照组接受甲状腺近全切除术，观察组进行甲状腺次全切除术，术后15 d对患者效果进行评估，然后行空腹静脉抽血。比较两组各项甲状腺激素的变化情况、治疗效果和并发症发生率。结果：两组手术前各项甲状腺激素比较，差异均无统计学意义（P>0.05）;觀察组各项甲状腺激素均明显高于对照组（P<0.05），观察组总有效率（98.33%）明显高于对照组（86.67%）（P<0.05），观察组并发症发生率明显低于对照组（P<0.05）。结论：甲状腺次全切术更能有效改善患者甲状腺各激素（T3、T4、FT3、FT4、TSH）水平，减少了并发症的发生，临床疗效更显著，使患者的生活质量得到更有效的改善，值得推广应用。

【关键词】 甲状腺次全切除术; 甲状腺近全切除术; 血清甲状腺素; 临床应用

Clinical Study on Early Changes of Thyroid Hormone after Subtotal Thyroidectomy and Near Total Resection/CHEN Yaozhi，ZOU Wei，QI Yinzhuo.//Medical Innovation of China，2019，16（22）：034-037

【Abstract】 Objective：To investigate the clinical study of early thyroid hormone changes after total thyroidectomy and near total resection.Method：A total of 120 patients undergoing thyroid surgery who underwent treatment from June 2017 to April 2019 were enrolled.The patients were randomly divided into control group（n=60）and observation group（n=60），according to the random number table method.The control group was treated with near total thyroidectomy，and the observation group was treated with subtotal thyroidectomy.The effect of the patients was evaluated on the 15th day，followed by fasting venous blood sampling.The serum thyroxine，efficacy and the incidence of complications of two groups were compared.Result：There was no significant difference in serum thyroxine between the two groups（P>0.05）.The serum thyroxine in the observation group was significantly higher than that in the control group（P<0.05）.The total effective rate of the observation group（98.33%）was significantly higher than that of the control group（86.67%），the difference was statistically significant（P<0.05）.The incidence of complications in the observation group was significantly lower than that in the control group（P<0.05）.Conclusion：Subtotal thyroidectomy can effectively improve the levels of thyroid hormones（T3，T4，FT3，FT4，TSH），reduce the incidence of complications，and the clinical effect is more significant，so that the quality of life of patients can be more effectively improved.It is worth promote the application.

【Key words】 Subtotal thyroidectomy; Subtotal thyroidectomy; Werum thyroxine; Clinical application

First-authors address：Beihai Peoples Hospital，Beihai 536000，China

doi：10.3969/j.issn.1674-4985.2019.22.009

近几年研究资料显示，不论是国内还是国外，对进行不同程度甲状腺切除手术后的患者体内血清甲状腺激素发生变化的相关研究特别少，没有做到全方位的总结分析。但是，随着医疗技术的不断发展，越来越多的研究者开始研究这个课题[1]。因为对不同程度的病情进行甲状腺切除术式不同，切除范围也不同，所以手术后，患者体内早期血清甲状腺激素也会发生不同的变化，同样的内分泌治疗开始和结束的时间也不同。相关研究发现，如果对患者进行甲状腺切除的范围越大，手术后患者甲状腺容易出现功能衰退的情况，因为患者体内血清甲状腺激素流失较快，所以医护人员需对患者进早行内分泌治疗[2]。甲状腺结节术后，对患者使用外源性甲状腺激素行一定作用抑制治疗时，不同患者对药物的剂量反映不同，这种差异和患者的年龄、甲状腺腺体切除的范围或患者的性别等因素有关，而且进行数据统计时要结合手术前患者甲状腺的功能。随着……