甲状腺癌术中规范化神经监测与解剖学基础相关性的临床意义  

Clinical significance of relationship between intraoperative neuromonitoring during thyroid cancer surgery and anatomic basis

作　　者：李晨[1] 田文[1] 臧宇[1] 刘晓莉[2] 姚京[1] 陈凛[1] 

机构地区：[1]中国人民解放军总医院普通外科,北京100853 [2]吉林大学中日联谊医院甲状腺外科,长春130033

出　　处：《解剖学杂志》2015年第6期722-722,共3页Chinese Journal of Anatomy

基　　金：北京市科技计划课题“首都特色”专项(Z141107002514102)

摘　　要：目的:探讨喉返神经监测对喉返神经解剖变异的识别、辨认及保护.方法:回顾性分析2012年3月至2014年3月在本院因甲状腺癌行双侧甲状腺全切术并行术中神经监测患者的临床资料,术中对颈部喉返神经解剖进行再认识与研究.结果:120例患者术中显露喉返神经共223根,其中发现解剖变异53根(23.7％).在喉返神经监测导引下,准确识别喉返神经走行路径、分支数目、毗邻关系变异分别为17根(7.62％)、12根(5.38％)、24根(10.76％);其中,混合性变异11根(11/53).结论:喉返神经解剖变异是导致术中对神经的错误识别以及造成神经损伤的重要潜在因素;喉返神经监测有利于术中确认各种变异的解剖特点,以有效保护喉返神经.Objective:To explore the role of recurrent laryngeal nerve monitoring techniques in finding,identifying and protecting recurrent laryngeal anatomic variations.Methods:Clinical data of 120 patients who underwent total thyroidectomy for thyroid cancer with recurrent laryngeal nerve monitoring techniques between March 2012 and March 2014 in our hospital were retrospectively analyzed and anatomy of recurrent laryngeal nerve during the operations was studied.Results:223 nerves were revealed in 120 patients with 53 anatomic variation nerves.With the help of recurrent laryngeal nerve monitoring techniques,17(7.62%) nerves travelling path were mapped;12(5.38%) nerves number of branches were indentified.24(10.76%) nerves neighbor relation was clarified;11(11/53) other anatomic variation nerves were found.Conclusion:Anatomic variation of recurrent laryngeal nerve is a vital factor causing misidentification and even nerve injury during operations;intraoperative neuromonitoring has an advantage of confirming all kinds of anatomic variations so as to effectively protect recurrent laryngeal nerves.

关 键 词：甲状腺癌 术中神经监测 喉返神经 解剖变异 

分 类 号：R736.1[医药卫生—肿瘤] R322[医药卫生—临床医学]