甲状腺手术中喉不返神经解剖操作技巧及临床意义  

Anatomical Technique and Clinical Significance of the Non- recurrent Laryngeal Nerve in Thyroid Surgery

作　　者：韩国达[1] 白希永[1] 陆志良[1] 

机构地区：[1]河北省沧州市中心医院肿瘤外一科,061001

出　　处：《中国全科医学》2015年第3期339-341,共3页Chinese General Practice

摘　　要：目的探讨喉不返神经的临床解剖操作技巧,总结甲状腺手术中如何识别喉不返神经及避免喉不返神经损伤的经验。方法对2005年1月—2011年12月在沧州市中心医院肿瘤外科行暴露喉返神经甲状腺手术的2 385例患者进行回顾性研究,分析术中寻找、暴露喉返神经的情况。结果甲状腺手术中共暴露喉返神经2 818根,术中发现喉不返神经6根(0.21%),其中Ⅱ型喉不返神经4根、Ⅲ型喉不返神经2根,全部发生于右侧。其中1例Ⅲ型喉不返神经出现误伤,术后声音嘶哑。结论喉不返神经发生率低,大多数位于右侧,容易被误伤。术中确切游离喉返神经全程前应该避免切断横行的条索状组织。如果术中常规位置未发现喉返神经,应当警惕喉不返神经的存在。Objective To explore the anatomical technique of the non - recurrent laryngeal nerve and to summarize the experience of how to discern and prevent the injury of this nerve in thyroid surgery. Methods The clinical data of 2 385 cases of thyroid surgery exposing the recurrent laryngeal nerve from January 2005 to December 2011 in the Department of Oncology of Cangzhou Center Hospital were analyzed retrospectively to analyze the finding and exposing of the recurrent laryngeal nerve during the surgery. Results Among all the cases,2 818 recurrent laryngeal nerves were exposed. All non - recurrent laryngeal nerves in the right - lateral neck were found in 6 cases and the incidence was 0. 21% . There were four type Ⅱnon - recument laryngeal nerves,and two type Ⅲ. One case of type Ⅲ was found having postoperatively vocal cord paralysis due to accidental nerve injury. Conclusion The incidence of non - recurrent laryngeal nerve is low,and the non - recurrent laryngeal nerve is always found in the right - lateral neck which is easy to be injured. Cutting cord - like things should be very cautious before conform the recurrent laryngeal nerve during operation. If the recurrent laryngeal nerve wasnˊt found in regular position,we should take the existence of non - recurrent laryngeal nerve into consideration.

关 键 词：甲状腺疾病 外科手术 喉返神经 喉不返神经 

分 类 号：R653.2[医药卫生—外科学]