甲状腺手术中显露喉返神经对预防喉返神经损伤的研究  

Study on exposure of recurrent laryngeal nerve in thyroid operation for the prevention of recurrent laryngeal nerve injury

作　　者：张波涛[1] 蔡婵艳[2] 

机构地区：[1]荆州市第一人民医院血管外科,湖北荆州434000 [2]荆州市第一人民医院心血管科,湖北荆州434000

出　　处：《局解手术学杂志》2015年第5期539-541,共3页Journal of Regional Anatomy and Operative Surgery

基　　金：湖北省荆州市科技发展计划基金(2012PE01-65)

摘　　要：目的研究显露喉返神经甲状腺手术对预防喉返神经损伤的临床价值。方法将2012年4月至2014年8月在我院接受甲状腺手术的90例患者纳入研究对象,根据术中是否显露喉返神经分为观察组和对照组(各45例),观察组患者行显露喉返神经的甲状腺手术,对照组患者行常规甲状腺手术,比较2组患者发生喉返神经损伤的情况以及手术情况。结果观察组患者术后出现喉返神经损伤症状的例数(2.22%)少于对照组(15.56%),2组比较差异有统计学意义(P<0.05);观察组患者的手术时间(54.45±6.62)min,明显长于对照组(41.29±5.82)min,2组比较差异有统计学意义(P<0.05);损伤恢复时间(5.85±0.85)d,明显短于对照组(8.02±1.12)d,2组比较差异有统计学意义(P<0.05);2组术中出血量、术后引流量以及术后引流持续时间比较,差异无统计学意义(P>0.05)。结论甲状腺手术中显露喉返神经能够预防喉返神经的损伤,降低损伤恢复时间,虽然会延长手术时间,但是不会增加出血量和引流量。Objective To study the clinical value of exposure of recurrent laryngeal nerve in thyroid operation for the prevention of recurrent laryngeal nerve injury. Methods A total of 90 patients received thyroid operation in our hospital from April 2012 to August 2014 were enrolled and randomly divided into observation group（ n = 45） and control group（ n = 45） according to whether the recurrent laryngeal nerve were exposed during operation. The patients in observation group received thyroid operation with recurrent laryngeal nerve exposure,and the patients in control group received conventional thyroid operation. Then recurrent laryngeal nerve injury situation and operation situation were compared. Results Recurrent laryngeal nerve injury symptoms were less in the observation group（ 2. 22%） compared with that of the control group（ 15. 56%） with a statistically singnificant difference（ P〈0. 05）. The operation time of observation group（ 54. 45 ±6. 62） min was longer than that of the control group（ 41. 29 ± 5. 82） min with a statistically singnificant difference（ P〈0. 05）. The recovery time of observation group（ 5. 85 ± 0. 85） d was shorter than that of the control group（ 8. 02 ± 1. 12） d,with a statistically singnificant difference（ P〈0. 05）. There was no significant difference in bleeding volume during operation,postoperative drainage volume and drainage duration between two groups（ P〉0. 05）. Conclusion Exposure of recurrent laryngeal nerve in thyroid operation is helpful to prevent recurrent laryngeal nerve injury,which reduce the damage recovery time,although it will extend the operation time,does not increase bleeding and drainage volume.

关 键 词：甲状腺手术 甲状腺疾病 喉返神经 声音嘶哑 

分 类 号：R322.51[医药卫生—人体解剖和组织胚胎学]