Study Of Clinical Contrast Of Primary Hyperthyroidism After The Two Different Subtotal Thyroidectomy

Objective: Primary hyperthyroidism is a common endocrine disease, most of patients are young female. It has three treatments, the first is antithyroid drug, cure rate of which is approximately50%; the second is ¹³¹I which shows micro-invasive, but the indication is narrow and it can revoke hypothyroidism; open subtotal thyroidectomy cures 90%～95% patients, except for scar in neck. Some patients need a new treatment which not only cures disease but also conceals scar, endoscopic subtotal thyroidectomy gives into birth. In fact, endoscopic thyroidectomy and open thyroidectomy gain the effect through removing most glandular organ, surgeon evaluate glandular organ by touching. Because endoscopic thyroidectomy lacks of tactus, it is hard to evaluate glandular organ well. Through perfecting preoperative examination,measurement of operation and follow-up investigation, the topic is to compare the operative hemorrhage,complication after operation,satisfaction of incision of 60 patients who were done open thyroidectomy or endoscopic thyroidectomy. From a new direction, to discuss the safety of endoscopic thyroidectomy.Methods: 60 patients were treated with open subtotal thyroidectomy (OT) or endoscopic thyroidectomy (ET) from April 2005 to December 2006, analyzing operation time,operative hemorrhage,soreness,nerve injury and the thyroid hormones of postoperation in 4 months etc. measurement data displayed by mean±standard deviation ((?)±S), used independent-samples T test; thyroid hormones of postopertion in 4months used repeated measure design. Enumeration count data displayed by frequency, used Chisquare test.Result: In the group ET and OT, the statistics was significant difference in operative hemorrhage (t=2.55, P=0.016＜0.05), length of stay of postoperation (t=5.08, P=0.000＜0.01), the satisfaction of incision (t=-9.80, P=0.000＜0.05), FT₄ of postoperation in 4months (F=6.22, P=0.015＜0.05), the amount of drainage (t=-16.85, P=0.000＜0.01)and days of drainage(t=-26.72, P=0.000＜0.01); the statistics was similar in operation time(P=0.649), soreness(P=0.288 ), nerve injury(P=0.554), deadlimb (P=0.301 ), FT₃ and TSH of postoperation in 4months (P=0.553, P=0.900) etc.Conclusion: In the group ET, operative hemorrhage was few, length of stay of postoperation was short, the satisfaction of incision was high. In the group OT, the amount of drainage was few, the days of drainage was short, FT₄ of postoperation in 4months were low. Through comparing with postoperative complication and short-term follow-up, ET is a effect treatment, but we need long-term follow-up and more cases for safety appreciation.