甲状腺手术中喉返神经解剖的意义  

Significance of the laryngeal recurrent nerve anatomy in the thyroidectomy

作　　者：邵渊[1] 陈阳静[1] 闫利英[1] 张少强[1] 白艳霞[1] 

机构地区：[1]西安交通大学医学院第一附属医院耳鼻咽喉头颈外科,西安710061

出　　处：《山西医科大学学报》2013年第9期741-743,共3页Journal of Shanxi Medical University

基　　金：国家自然科学基金资助项目(30901946)

摘　　要：目的探讨甲状腺手术中探查解剖喉返神经的意义。方法对2009—02～2012—02本科收治的甲状腺手术患者252例，术中常规探查喉返神经，探讨防止喉返神经损伤的方法。结果所有病例均成功探查喉返神经，252例患者共374条，其中喉返神经位于甲状腺下动脉深面走行的212条（56．7％），走行于动脉分支之间的88条（23．5％），走行于动脉前面的73条（19．5％），喉不返神经1条（0．3％）。术后15例出现单侧声带活动障碍，13例患者恢复正常，2例未恢复正常。结论甲状腺手术中探查喉返神经是防止术后喉返神经麻痹的有效方法，对于术后声音嘶哑患者的原因分析具有重要的意义。Objective To explore the significance of the laryngeal recurrent nerve exposure during the thyroidectomy. Methods From February 2009 to February 2012 ,the laryngeal recurrent nerve of 252 patients in department of otorhinolaryngology-head and neck were routinely probed during the thyroid gland operation to explore the ways in prevention of the laryngeal recurrent nerve injury. Re- sults Totally 374 laryngeal recurrent nerves of 252 patients were successfully probed during the operation. Totally 212 laryngeal recur- rent nerves （56.7 % ）passed through under the thyroid gland artery, 88 laryngeal recurrent nerves （23.5 % ） passed through the line be- tween the thyroid gland artery branches,73 laryngeal recurrent nerves（ 19.5% ） passed through on the top of the thyroid gland artery, and 1 （0.3 % ）laryngeal non-recurrent nerve was found. After operation, 15 cases of unilateral vocal cord paralysis occurred, of which 13 cases recovered in the follow-up of 1 year and 2 cases failed to recover. Conclusion During the operation of the thyroidectomy,the la- ryngeal recurrent nerve exposure is an effective method in prevention of the postoperative laryngeal recurrent nerve paralysis. It is of high significance for the analysis of the postoperative hoarseness.

关 键 词：甲状腺 喉返神经 甲状腺下动脉 环甲关节 

分 类 号：R767[医药卫生—耳鼻咽喉科]