Complications after thyroidectomy

Content

  • thyrotoxic crisis
  • Bleeding from the wound
  • Damage to the recurrent laryngeal nerve
  • hypoparathyroidism



  • thyrotoxic crisis

    It occurs in patients with a priorthyrotoxicosis, who did not receive treatment or not received in full. The clinic is manifested in the operating room or intensive care unit. Hyperthermia, sweating, tachycardia, nausea, vomiting, pain. Tremor and lethargy may progress to delirium and coma. Treatment involves large doses of saline intravenously or potassium iodide, 100 mg of cortisol, oxygen therapy, high doses of glucose, correction fluid and electrolyte balance, a temperature reduction. The mortality rate approaching 10%.


    Bleeding from the wound

    Complications after thyroidectomyIt occurs during the first hour after surgery. The causes of respiratory disorders is a small amount of blood in the deep spaces behind the trachea, which may cause obstruction of the airways (0.3-1%). Treatment: Immediately. In opiratsionnoy - revision of the wound, the evacuation of clots to normalize the pressure of the surrounding tissue, ligation of bleeding vessels.


    Damage to the recurrent laryngeal nerve

    In carrying out operations on the thyroid glandIt is 1-3%. It may be a one- or two-way, temporary or permanent. With paralysis of the laryngeal muscles of the vocal cords take the middle position. The voice becomes hoarse. Bilateral vocal cord paralysis does not prevent the passage of air.


    hypoparathyroidism

    0,6-2,8%. The greater the number (up to 9%), and malignant diseases, relapses. Rarely occurs as a result of the removal of all glands are more likely due to damage of the blood supply. Minimum risk of thyroid vascular ligation. Parathyroid impaired blood supply can be ground and implanted into grudinoklyuchichno-mastoid muscle.

    The clinic is manifested during the first days afteroperation. Circular limb numbness, tingling fingertips, anxiety. Sooner appear positive symptom chvostek then Trousseau and karpopedalny spasm. Possible convulsions. Serum calcium was reduced, increased phosphorus. The condition can be transient (a few days) or permanent.

    Treatment starts with the introduction of intravenous bolus10 ml of 10% calcium glyukondta, then drip 2-3 ampoules every 8h. For permanent hypoparathyroidism need vitamin D (rokaltrol at 0.25-0.5 mg daily in addition to calcium), the measurement of the calcium and phosphorus levels. In hypoparathyroidism phosphorus levels increased. Low levels seen with "hungry bone syndrome".

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