喉返神经显露在甲状腺手术中的应用

[目的]探讨喉返神经显露对减少甲状腺手术中喉返神经损伤的作用。[方法]随机将行甲状腺一侧或双侧腺叶全切术患者分成显露喉返神经组和不显露喉返神经组 ,并对其结果进行比较。[结果]显露组697例共显露喉返神经723条 ,术中致喉返神经暂时性损伤10例 ,永久性损伤4例 ,其中3例为喉返神经被癌组织侵范而一并切除 ;不显露组311例 ,术中致喉返神经暂时性损伤11例 ,永久性损伤12例 ,其差异具统计学意义(P<0 01)。[结论]在行一侧或双侧甲状腺腺叶全切除术中 ,常规显露喉返神经能明显减少喉返神经的损伤率。但对仅作甲状腺腺叶次切或遇巨大甲状腺肿瘤的手术时应按具体情况分别对待。

Exposure of Recurrent Laryngeal Nerve in Thyroid Surgery for Thyroid

To investigate the role of decreasing recurrent laryngeal nerve injury in surgery for thyroid by exposure the nerveThe patients with unilateral orbilateral thyroid lobectomy were divided randomized into two groups,nerve exposure group and non exposure groupThe result was comparedThere were 723 nerves presented in 697 cases in exposure group during operation,and 10 cases with temporary injury of recurrent nerve and 4 cases wigth permanent injury (3 cases with resection of recurrent nerve invaded by cancer) In 311 cases ofnonexposure,there were 11 temporary injuries and 12 permanent injuries during operationThere was significant difference between 2 group(P<001)[Conclusion]Recurrent laryngeal nerve exposure can greatly decrease the nerve injury in unilateral or bilateral total lobectomy of thyroidBut treatment in subtotal lobectomy of thyroid or large carcinoma of thyroid should be tailored to the individual