再谈甲状腺手术喉返神经损伤的相关因素  

Further discussion on relative factors of recurrent laryngeal nerve injury during thyroid operations

作　　者：朱一鸣 刘绍严 ZHU Yi-ming;LIU Shao-yan.(Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical Colleg;National Cancer Center, Beijing 100021, China)

机构地区：[1]国家癌症中心中国医学科学院北京协和医学院肿瘤医院,北京100021

出　　处：《中国实用外科杂志》2018年第6期607-612,共6页Chinese Journal of Practical Surgery

摘　　要：喉返神经损伤是甲状腺手术的常见并发症之一,会严重影响病人的生活质量。但喉返神经损伤并非仅与术中操作有关。其影响因素很多,涉及解剖、病例特点、围手术期评估、术中操作、手术范围、能量器械应用、术中神经监测技术(IONM)应用等。坚持充分的术前评估、制定合理的手术计划和切除范围、术中精细被膜解剖、正确合理应用能量器械、规范使用IONM,能够最大程度减少喉返神经损伤,提高病人术后生活质量。Recurrent laryngeal nerve injury is one of the most common complications of thyroid surgery and can seriously affect the quality of life of patients. However, recurrent laryngeal nerve injury is not only related to intraoperative maneuvers.A review of the literatures found that there are many factors related to recurrent laryngeal nerve injury during thyroid surgery, including anatomy of the nerve, characteristics of cases, perioperative assessment, intraoperative procedures, extent of surgery, application of energy devices, and application of IONM technology. Adhering to adequate preoperative evaluation, establishing a reasonable surgical plan and extent of resection, intraoperative meticulous membrane dissection, proper and rational application of energy devices, and standardized use of IONM technoh）gy can minimize recurrent laryngeal nerve injury and improve postoperative patient quality of life.

关 键 词：甲状腺手术 喉返神经损伤 影响因素 

分 类 号：R6[医药卫生—外科学]