甲状腺手术中解剖和识别Zuckerkandl结节的意义  

Significance of exposing and recognizing Zuckerkandl＇s tubercle during thyroidectomy

作　　者：张殿龙[1] 曹铭谦[1] 王晓兰[1] 姚永强[1] 刘涛[1] 方红[1] 解继平[1] 程晓宇[1] 

机构地区：[1]大连大学附属中山医院乳腺甲状腺外科,116001

出　　处：《中国综合临床》2012年第5期544-546,共3页Clinical Medicine of China

摘　　要：目的探讨甲状腺手术中解剖和识别Zuckerkandl结节（ZT）的意义。方法选择我院2009年1月至2011年6月进行的370例（501侧）甲状腺侧叶切除或全切除病例，在术中解剖和识别ZT，并观察其与喉返神经（RLN）及上甲状旁腺（sP）的关系。结果发现ZT为412侧（82．2％，412／501），其中ZT出现在甲状腺叶的后外侧中1／3者为368侧（89．3％，368／412）。RLN走行在ZT后方者为379侧（92．0％，379／412）。当ZT位于甲状腺叶的后外侧中1／3及下1／3时，sP均位于zT的头侧偏前方，且80．1％的SP与ZT紧邻。RLN损伤发生率为0．40％（2／501），无sP损伤发生。结论在甲状腺手术中解剖和识别ZT，有助于识别和保护RLN及SP，从而减少手术并发症的发生，具有重要的临床意义。Objective To Explore the significance of successful exposing and recognizing Zuckerkandl＇s tubercle （ZT） during thyroidectomy. Methods Three hundred and seventy patients （ 501 sides） underwent lobectomy or total thyroidectomy from January 2009 to June 2011 were included in this study. The ZT was assessed in terms of its presence or absence, size and anatomical association with the recurrent laryngeal nerve （RLN） and superior parathyroid （SP）. Results ZTs were found in 412 of 501 sides （ 82. 2% ）, among which 368 （89. 3% ） ZTs were located in the middle third of the lateral lobe of the thyroid gland. ZTs passed over the RLN in 379 of 412 sides（92.0% ）. When the ZTs were located in the middle or lower third of the lateral lobe of the thyroid gland, the SPs were all located in the cranial portion of ZT. The SP was adhered to the ZT in 80. 1% of the cases. RLN damage rate was 0.40%, and no SP damage occurred. Conclusion Exposing and recognizing Zuckerkandl＇s tubercle during thyroidectomy is of important clinical significance, which helps to identify and protect RLN and SP, so as to reduce surgical complications.

关 键 词：甲状腺切除术 Zuekerkandl结节 喉返神经 甲状旁腺 手术并发症 

分 类 号：R653[医药卫生—外科学]