甲状腺手术中解剖喉返神经的意义

目的探讨甲状腺术中解剖喉返神经（recurrent laryngeal nerve，．RLN）在预防神经损伤中的作用。方法回顾性分析2000年5月至2007年9月340例甲状腺肿瘤的临床资料，172例术中常规解剖喉返神经，168例按传统方法对喉返神经行径区进行保护，未解剖喉返神经。结果解剖喉返神经组喉返神经暂时性损伤1例，无永久性损伤病例，损伤率为0．6％；未解剖喉返神经组暂时性损伤6例，永久性损伤2例，总损伤率为4．8％，经统计学处理（X^2检验），差异有统计学意义（P〈0．05）。结论熟悉喉返神经的解剖特点和变异，术中正确辨认喉返神经，行甲状腺手术时解剖显露喉返神经能降低喉返神经损伤的发生率并有利于提高手术疗效。

The significance of anatomizing the recurrent laryngeal nerve in thyroid surgery

Objective To investigate the role of anatomizing the recurrent laryngeal nerve (RLN) in preventing the injury in thyroid surgery. Methods The clinical data of 340 eases with thyroid tumour from May 2000 to september 2007 were retrospective analyzed. In 172 eases,RLN was exposed generally. In 168 cases thatRLN was not exposed,had thyroidectomy with protection of anatomical region. Results Temporary nerve injury was in 1 cases(0. 6%) in RLN exposure group. Temporary nerve injury and permanent nerve injure occurred re- spectively in 6 cases and 2 eases(4. 8%)in RLN non-exposure group. There was significant difference between two groups(P < 0.05). Conclusion The familiarity of the anatomy characteristic and variation of RLN, and the exposure and correct identification of RLN in thyroid operation,the rate of the RLN injury could be reduced and the effect of the treatment could be improved.