甲状腺手术中喉返神经损伤分析  

Analysis of Recurrent Laryngeal Nerve Trauma during Operation of Thyroidectomy

作　　者：赵卫东[1] 刘阳[1] 张美超[1] 

机构地区：[1]南方医科大学解剖教研室,广州市510515

出　　处：《医药论坛杂志》2006年第16期1-2,6,共3页Journal of Medical Forum

基　　金：国家自然科学基金(30371449)

摘　　要：目的分析甲状腺手术中喉返神经损伤发生的原因。方法对215例甲状腺手术病人进行回顾性分析。术中未显露喉返神经141例,术中常规显露喉返神经74例,观察喉返神经损伤发生率。结果未解剖显露喉返神经组甲状腺切除术141例中,暂时性喉返神经损伤发生率4.8%,永久性喉返神经损伤发生率3.5%;解剖喉返神经组暂时性喉返神经损伤发生率5.6%,永久性喉返神经损伤发生率1.3%。暂时性喉返神经损伤发生率未见有显著差异(P>0.05),永久性喉返神经损伤发生率比后者显著升高(P<0.05)。结论解剖变异、手术操作、组织粘连是甲状腺手术损伤喉返神经的主要原因。甲状腺手术中显露喉返神经应该有选择性。Objective To analyze the reason of recurrent laryngeal nerve traumas during the operation of thyroidectomy. Methods To retrospectively study 215 cases with thyroid disease underwent thyroidectomy, the incident rates of laryngeal nerve traumas were compared between the group 1 of exposure of recurrent laryngeal nerve during the procedure of thyroidectomy （141 cases） and the group 2 （74 cases）. Results The rate of temporary recurrent laryngeal nerve traumas was 5.6% and the rate of permanent recurrent laryngeal nerve traumas was 1.3% in group 1. The rates were 4.8% and 3.5% respectively in the group 2 （ P 〉0. 057. The incidence rate of temporary recurrent laryngeal nerve injuries was no difference in 2 groups, but the incidence rate of permanent recurrent laryngeal nerve traumas in group 1 was lower than that in group 2 （ P 〈 0. 05）. Conclusion The primary reasons of recurrent laryngeal nerve trauma during the operation of thyroidectomy were the variation of anatomy, the procedure of thyroidectomy and the conglutination of tissue. Exposure of recurrent laryngeal nerve trauma during the operation of thyroidectomy should be selected.

关 键 词：喉返神经 甲状腺手术 神经损伤 

分 类 号：R643[医药卫生—外科学]