甲状腺手术中喉返神经的保护

目的:探讨甲状腺手术中保护喉返神经的方法。方法:术前经B超证实36例甲状腺疾病患者病变部位、范围及性质,术中依靠一些解剖标志寻找和识别喉返神经并加以保护。结果:36例患者术后32例无声带并发症,4例术后声嘶,随访3~6个月,2~6个月声嘶恢复正常。结论:手术中解剖喉返神经必须遵循规范化操作原则,首先在甲状腺下极甲状腺下动脉周围寻找喉返神经,若有困难可在喉返神经入喉处,亦可在颈动脉鞘迷走神经附近寻找。

Protection of recurrent laryngeal nerve in thyroid surgery

Objective: To explore the methods of protection of recurrent laryngeal nerve in thyroid surgery.Methods: From Febuary 2004 to January 2005,36 cases accepted thyroid surgeries in our department.In the operation,their recurrent laryngeal nerves were better protected with the help of some dissection symbols.Results: After the operation,21 cases were diagnosed as having thyroid gland adenoma,5 nodular goiter,3 subacute thyroiditis,3 thyroid function hyperfunction,and 4 thyroid cancer.Of the 36 cases,32 had no vocal cord illness complication,while the other 4 had hoarseness and recovered after 2-6 months.Conclusions: Based on some dissection symbols, the recurrent laryngeal nerve damage and some surgery complications are avoided.The dissection of recurrent laryngeal nerve must follow the principle of standardized operation.Recurrent laryngeal nerve can be dissected around the inferior thyroid artery first.If it is difficult to find,it can be dissected around the thyroid cartilage or the cervical vagus inside of carotid sheath.