甲状腺切除术中喉返神经解剖与未解剖对其损伤的比较研究  

A comparative study on nerve exposing versus no exposing for avoiding recurrent laryngeal nerve injury in thyroidectomy

作　　者：覃谦[1] 李洪[1] 王力斌[1] 李爱辉[1] 欧阳杰[1] 梁卓虹[1] 谢书勤[1] 

机构地区：[1]中山大学附属东华医院外六科,东莞523110

出　　处：《中华内分泌外科杂志》2010年第6期405-408,共4页Chinese Journal of Endocrine Surgery

摘　　要：目的 比较甲状腺切除术中解剖和未解剖喉返神经（RLN）预防其损伤的发生率.方法 回顾性分析甲状腺切除术中RLN解剖（472例,639侧次）与未解剖（232例,296侧次）临床资料,比较两者间并发RLN损伤几率.结果 解剖组：RLN暂时损伤为1.49%（7/472）,无永久性损伤,暂时性甲状旁腺功能低下为1.69%（8/472）.未解剖组：暂时损伤为6.03%（14/232）,永久性损伤2.16%（5/232）.术中RLN解剖与未解剖比较,手术时间和RLN永久性损伤差异有统计学意义（P＜0.01）.结论 甲状腺切除术中RLN解剖与未解剖相比前者虽然增加手术时间,但对预防或避免医源性RLN损伤有重要意义.Objective To compare the incidence of recurrent laryngeal nerve （RLN） injury in thyroidectomy with or without exposing RLN. Methods Records of 704 patients in our hospital undergoing thyroidectomy were retrospectively studied, among whom 472 patients underwent thyroidectomy with RLN being exposed and 232 underwent thyroidectomy without RLN being exposed. Results The incidence of RLN temporary damage and permanent damage in RLN exposed group was 1.49% （7/472） and 0, while it was 6. 03% （14/232）and 2. 16%（5/232） in the non-exposed group. There was statistic difference between the two groups in terms of permanent injury incidence and operation duration （P 〈 0. 01）. Conclusions Although the operation duration was prolonged in RLN exposure group, RLN exposure during operation is very helpful to prevent recurrent laryngeal nerve injury. Therefore, it＇s necessary to expose RLN during operation in sub-total thyroidectomy and total thyroidectomy.

关 键 词：甲状腺切除术 喉返神经损伤 甲状腺疾病 

分 类 号：R653[医药卫生—外科学]