甲状腺外科手术中喉不返神经的解剖研究  

Intraoperative identification of the nonrecurrent laryngeal nerve during thyroid surgery

作　　者：邵堂雷[1] 杨卫平[1] 王海[2] 丁家增[1] 金筱泰[1] 殷家晗[2] 吴志浩[2] 蔡伟耀[1] 李宏为[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院普外科,上海200025 [2]上海瑞金医院远洋分院外科

出　　处：《中华普通外科杂志》2009年第12期963-965,共3页Chinese Journal of General Surgery

摘　　要：目的探讨甲状腺手术中如何识别和避免误伤喉不返神经。方法回顾性分析1998年1月至2008年12月3078例甲状腺手术患者的临床资料。结果3078例患者接受了显露喉返神经的甲状腺手术，共解剖喉返神经4241根。发现喉不返神经12根（0．28％，12／4241），全部位于右侧；其中男性1例，女性11例。12根中Ⅰ型有2根（16．67％，2／12），Ⅱ型有6根（50％，6／12），Ⅲ型有4根（33．33％，4／12）。有1根Ⅰ型喉不返神经术中被误伤（8．33％，1／12）。结论甲状腺手术中只要采取正确的解剖方法常规全程显露喉返神经，就可以尽可能的识别和避免误伤喉不返神经。Objective To discuss how to identify the nerve and prevent the injury of the nonrecurrent laryngeal nerve during thyroid surgery. Methods The clinical data of 3078 patients undergoing thyroid resection were retrospectively analyzed. Results From January 1981 to December 2001, 3078 thyroidectomy was performed at our department with the routine exploration of the recurrent laryngeal nerve. 4241 recurrent laryngeal nerves were identified, among them there were 12 nonrecurrent laryngeal nerves（0. 28% ,12/4241 ） ,of which all were fight-sided. One patient was male and 11 female. Of these 12 cases, there were 2 of type Ⅰ （16. 67% ,2/12）, 6 of type Ⅱ （50% ,6/12） and 4 of type Ⅲ （33.33 % ,4/12）. One of the type Ⅰ patients suffered from intraoperative injury of his nonreurrent laryngeal nerve. Conclusions The careful intraoperative identification of the nonrecurrent laryngeal nerve helps prevent it from the inadvertent injury.

关 键 词：甲状腺切除术 解剖学 喉不返神经 手术中并发症 

分 类 号：R686[医药卫生—骨科学]