甲状腺手术中喉返神经的显露及保护方法探讨  

Study on exposure of recurrent laryngeal nerve and its preventive measures in thyroid gland surgery

作　　者：杨红丽[1] 李延清 冯蓉[1] 拓明祥 田青[1] 

机构地区：[1]延安市人民医院耳鼻咽喉科,陕西延安716000 [2]延川县人民医院耳鼻喉科,陕西延川717200

出　　处：《现代医药卫生》2011年第15期2265-2267,共3页Journal of Modern Medicine & Health

摘　　要：目的:探讨甲状腺手术中喉返神经损伤的原因及防治措施。方法:回顾性分析我科2007～2011年的107例甲状腺手术患者的临床资料。结果:解剖喉返神经93例110条,行于气管食管沟99条,气管食管沟旁11条,从甲状腺下动脉总干深面通过83条,从动脉分叉深面通过9条,从动脉总干浅面通过5条,从动脉分叉浅面通过2条,从动脉分叉之间通过1条。术后单侧声带活动受限4例,单侧声带固定1例,无双侧声带活动同时受限或固定。经治疗1～3个月声带活动正常4例,改善1例。结论:甲状腺术中是否常规解剖喉返神经取决于术式选择,解剖并保护喉返神经是避免损伤的重要方法之一。Objective：To study the causes and preventive measures of recurrent laryngeal nerve injury in thyroid gland surgery.Methods：The retrospective analysis was performed on 107 cases of thyroid gland surgery in our department during 3 years between 2007-2011.Results：110 recurrent laryngeal nerves were intraoperatively dissected in 93 cases.Recurrent laryngeal nerves traveling in tracheoesophageal groove were in 93 cases,traveling along lateral side of tracheoesophageal groove in 11 cases,passing through deep surface of main branch of inferior thyroid artery in 83 cases,passing through deep surface of arterial bifurcation in 9 cases,passing through shallow surface of arterial common branch in 5 cases,passing through shallow surface from artery bifurcation in 2 cases and passing between arterial bifurcation in 1 case.Unilateral vocal cord activity was postoperatively limited in 4 cases.Unilateral vocal cord was fixed in 1 cases.No case had the activity limitation or fixation in bilateral vocal cords.After 1-3 months treatment,there were 4 cases of normal vocal cord activity and 1 case of improvement.Conclusion：Whether intraoperative routine anatomy of recurrent laryngeal nerve in thyroid gland surgery depends on the surgical methods.Dissecting and protecting recurrent laryngeal nerve is one of the important ways to avoid damage.

关 键 词：甲状腺手术 解剖 喉返神经 

分 类 号：R76[医药卫生—耳鼻咽喉科]