甲状腺手术显露喉返神经预防永久性神经损伤  

Exposure recurrent laryngeal nerves during the procedure of thyreoidectomy to prevent permanent nerve injuries

作　　者：毛晓峰[1] 周连帮 洪晓明 

机构地区：[1]江山市人民医院外二科,浙江省江山324100 [2]浙江省宁波市鄞州第二人民医院普外科

出　　处：《中国基层医药》2006年第1期77-78,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨甲状腺手术中常规解剖显露喉返神经能否预防永久性神经损伤。方法对1980年1月至2004年12月手术治疗的1523例甲状腺疾病进行回顾性分析。在1523例中,术中未显露喉返神经1249例,术中常规显露喉返神经274例,观察两组术后永久性喉返神经损伤发生率和暂时性喉返神经损伤发生率。结果1523例中共发生永久性喉返神经损伤50例,其中未显露喉返神经组发生47例(47/1249,3.8%),显露喉返神经组发生3例(3/274,1.1%),前者永久性喉返神经损伤发生率比后者显著升高(P<0.05)。两组中暂时性喉返神经损伤发生率未见有显著差异(P>0.05)。结论术中常规显露喉返神经是甲状腺切除手术中预防喉返神经永久性损伤的有效方法。Objective To investigate whether routine exposure recurrent laryngeal nerves（RLN） during the procedure of thyreoideetomy would prevent permanent nerves injuries caused by thyroid surgery. Methods 1523 patients with thyroid disease underwent tbyreoidectomy from January 1980 to December 2004. Routine exposure of RLN during the procedure of thyreoidectomy were in 274 cases（group 1 ） and not in 1249 cases（group 2）, the incidence rates of temporary RLN injuries and permanent RLN injures were compared in these groups. Results 3 eases （3/274,1,1% ） occurred permanent RLN injuries in group 1 and 47 eases（47/1249,3.8% ） occurred RLN injuries in group 2. The incidence rate of permanent RLN injuries in group 1 was lower than that in group 2（ P 〈 0.05 ）, but there was no difference in the rate of temporary RLN injuries（P 〉 0.05） in these groups. Conclusion Exposure recurrent RLN during the procedure of thyreoidectomy can effectively prevent permanent nerves injuries caused by thyroid surgery.

关 键 词：甲状腺切除术 喉返神经 创伤 神经系统 甲状腺手术 预防 永久性神经损伤 

分 类 号：R653[医药卫生—外科学]