腔镜下甲状腺手术喉返神经损伤原因分析及预防(附3例报告)  

On causes and preventive measures of recurrent laryngeal nerve injury during endoscopic thyroidectomy:Report of 3 cases

作　　者：汪宏[1] 吴立胜[1] 涂从银[1] 邹兵兵[1] 

机构地区：[1]合肥市第一人民医院普外科Ⅱ病区,合肥230061

出　　处：《中国微创外科杂志》2007年第4期358-359,共2页Chinese Journal of Minimally Invasive Surgery

基　　金：安徽省卫生厅科研基金(06B067)

摘　　要：目的探讨腔镜下甲状腺手术喉返神经损伤的原因及防治措施。方法回顾分析2002年1月～2006年7月我院的101例腔镜下甲状腺手术中喉返神经损伤3例的临床资料。结果3例术后24h出现声音嘶哑,间接喉镜检查证实单侧声带运动较弱。损伤原因:超声刀热灼伤2例,局部组织水肿压迫伤1例,均为喉返神经暂时性麻痹。给予适当激素治疗,分别于术后3个月、3个月、20天恢复。结论腔镜下喉返神经的损伤与超声刀使用不当等手术操作有关,提高术者技术能减少此并发症发生,提高超声刀使用认识是其中关键之一。Objective To explore causes and preventive measures of recurrent laryngeal nerve injury during endoscopic thyroidectomy. Methods Clinical data of 3 cases of recurrent laryngeal nerve injury from 101 cases of endoscopic thyroideetomy in this hospital from January 2002 to July 2006 were retrospectively analyzed and summarized. Results There were 3 cases of hoarseness occurred at 24 h after operation. Under indirect laryngoscopy, the unilateral vocal cord was found immobile. The reasons leading to the injury included thermal burn by ultrasound knife in 2 cases and edema compression in 1 case. The injury was transient recurrent laryngeal nerve paralysis. The symptoms subsided spontaneously 3 months after operation in 2 cases and 20 days after operation in 1 case, respectively. Conclusions The recurrent laryngeal nerve injury is usually correlated with unskillful use of ultrasound knife. The improvement of surgeon＇ s technique is crucial to reduce the incidence of this complication.

关 键 词：腔镜下甲状腺手术 喉返神经 损伤 预防 

分 类 号：R653[医药卫生—外科学]