甲状腺祖克坎德尔结节的发生率及其临床解剖学意义  

Incidence and importance of the tubercle of Zuckerkandl in thyroid surgery

作　　者：王鸿程[1] 陈炯[1] 林晶[1] 高新基[1] 陈丽津[1] 

机构地区：[1]福建中医药大学附属第二人民医院甲状腺血管疝外科,福州350003

出　　处：《福建医药杂志》2014年第1期5-7,共3页Fujian Medical Journal

基　　金：福建省教育厅A类课题(JA10179);福建省教育厅B类课题(JB10179)

摘　　要：目的 探讨甲状腺手术中Zuckerkandl结节（TZ）与喉返神经（RLN）、上甲状旁腺（SP）的解剖位置关系及临床意义.方法 回顾性分析236例甲状腺手术（甲状腺癌63例,甲状腺良性疾病173例）患者的临床资料,观察TZ的有无、大小,及与RLN、SP的解剖关系.TZ根据大小进行分级：0级＝不能看到、Ⅰ级≤5 mm、Ⅱ级＝6～10 mm、Ⅲ级＞10 mm.结果 TZ在左侧出现为71.3%（117/164）,右侧为75.4%（104/138）.在左侧甲状腺叶,28.7%为0级,15.8%为Ⅰ级,24.4%为Ⅱ级,31.1%为Ⅲ级.在右侧甲状腺叶,24.6%为0级,15.9%为Ⅰ级,30.5%为Ⅱ级,29.0%为Ⅲ级.大多数RLN在TZ下方通过,同样,大多数SP位于TZ的颅侧.结论 TZ与RLN和SP之间有密切的解剖关系,可以作为甲状腺手术中显露保护RLN和SP的解剖学标志物.Objective To explore the anatomical relationship between Tubercle of Zuckerkandl （TZ） and Recurrent la- ryngeal nerve （RLN） and Superior Parathyroid （SP） during thyroidectomy. Methods A total of 236 patients （63 thyroid cancer and 173 benign diseases） underwent thyroidectomy were analyzed retrospectively in this study. The TZ was observed in terms of its presence or absence, size, and anatomical association with RLN and SP. TZ were classified according to size.. Grade 0 （unrecognizable）, Grade I （〈5 mm）, Grade II （6-10 ram）, and Grade III （〉10 mm）. Results TZ were identi- fied in most patients [left 71.3 % （117/164）, right 75.4% （104/138）]. The distribution of TZ according to grade was as follows.. Grade 0, left 28.7%, right 24.6%; Grade I , left 15.8%, right 15.9% Grade II , left 24.4%, right 30.5%; Grade III, left 31.1%, right 29.0%. The most common RLN run in a tunnel behind TZ. The majority of SP were cranial to the TZ. Conclusion There is an close anatomical relationship between TZ and RLN and SP. Therefore, TZ could be a land- mark for exposing and protecting RLN and SP during thyroidectomy.

关 键 词：祖克坎德尔结节 喉返神经 甲状旁腺 

分 类 号：R653[医药卫生—外科学]