甲状腺全切术中精细化被膜解剖结合环甲间隙显露喉返神经应用于甲状腺癌治疗的价值  

Application value of fine capsule anatomy combined with cricothyroid space exposure of recurrent laryngeal nerve in total thyroidectomy for patients with thyroid cancer

作　　者：金雄伟 李宏帅 杨祚豪 李满志 张浩 JIN Xiongwei;LI Hongshuai;YANG Zuohao;LI Manzhi;ZHANG Hao(Gastrointestinal and Thyroid Hernia Surgery Department of Dongguan Kanghua Hospital,Guangdong Dongguan 523080,China)

机构地区：[1]东莞康华医院胃肠甲状腺疝外科,广东东莞523080

出　　处：《临床普外科电子杂志》2022年第1期2-6,共5页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的 探讨甲状腺全切术中精细化被膜解剖结合环甲间隙显露喉返神经在甲状腺癌患者治疗中的应用价值。方法 选取2018年1月至2020年9月东莞康华医院接诊的90例甲状腺癌患者,按照随机数字表对照法分为对照组和观察组,每组45例。对照组行常规甲状腺全切术+甲状腺下动脉显露喉返神经治疗,观察组采取精细化被膜解剖结合环甲间隙显露喉返神经治疗,比较两组患者手术情况、手术前后甲状腺功能指标检测结果变化情况、术后并发症情况以及随访6个月复发情况。结果 两组患者手术时间、术中失血量、淋巴结清扫数目比较,差异无显著性(P> 0.05);观察组患者术后1d、3d血清甲状旁腺激素、Ca^(2+)水平高于对照组,差异有显著性(P<0.05);观察组患者术后喉返神经损伤、甲状旁腺功能减退、低钙血症发生率均低于对照组,差异有显著性(P <0.05);两组患者术后随访6个月复发率比较,差异无显著性(P> 0.05)。结论 甲状腺癌患者甲状腺全切术中进行精细化被膜解剖结合环甲间隙显露喉返神经有利于保护喉返神经和甲状旁腺功能。Objective To explore the application value of fine capsule anatomy combined with cricothyroid space exposure of recurrent laryngeal nerve in total thyroidectomy for thyroid cancer patients. Method 90 patients with thyroid cancer in Dongguan Kanghua Hospital from January 2018 to September 2020 were selected. They were randomly divided into two groups, with 45 cases in each group. The control group was treated with conventional total thyroidectomy and inferior thyroid artery exposure of recurrent laryngeal nerve, while the observation group was treated with refined capsule anatomy combined with cricothyroid space exposure of recurrent laryngeal nerve. The operation conditions, changes of thyroid function indexes before and after operation, postoperative complications and recurrence after 6 months of follow-up were compared between the two groups. Result There was no significant difference in the operation time, intraoperative blood loss and the number of lymph node dissection between the two groups(P > 0.05);The detection results of serum parathyroid hormone and Ca^(2+)in the observation group on 1 day and 3 days after operation were higher than those in the control group, and the difference was significant(P < 0.05);The incidence of recurrent laryngeal nerve injury,hypoparathyroidism and hypocalcemia in the observation group were lower than those in the control group, the difference between the data was significant(P < 0.05);there was no significant difference in the recurrence rate of the two groups after 6 months of follow-up(P > 0.05). Conclusion In total thyroidectomy for patients with thyroid cancer, fine capsule anatomy combined with exposure of recurrent laryngeal nerve in cricothyroid space is beneficial to protect the function of recurrent laryngeal nerve and parathyroid gland.

关 键 词：甲状腺癌 甲状腺全切术 精细化被膜解剖 环甲间隙 喉返神经 

分 类 号：R73[医药卫生—肿瘤]