甲状腺癌手术中喉返神经损伤的防治

目的探讨甲状腺癌手术中喉返神经（RLN）损伤的原因、预防及治疗措施。方法回顾性分析192例甲状腺癌行手术治疗患者的临床资料。结果192例患者患侧甲状腺常规显露RLN，术中发生3例RLN误伤，均行一期RLN吻合术，术后发音明显改善。有3例术后2～3d开始出现声嘶，3个月内发音基本恢复正常。有1例RLN被肿瘤包绕，行单侧RLN切除。结论RLN损伤的影响因素很多，有选择的显露RLN、精细无血操作、专科化培养的甲状腺外科医师等是预防的关键。RLN损伤一经诊断应尽早修复。

Prevention and treatment of recurrent laryngeal nerve injury during operation in patients with thyroid cancer

Objective To investigate the causes, prevention and treatment of recurrent laryngeal nerve (RLN) injury during operation in patients with thyroid cancer. Methods Clinical data of 192 patients undergone thyroidectomy operation were reviewed. Results RLN was exposed during operation in 192 patients. There were 3 cases of RLN injury, then RLN anastomosis was happened immediately during operation. It was significantiy improved in pronunciation after operation. 2 ～ 3 d after surgery, transitory hoarseness was observed in 3 patients. Unilateral RLN resection performed in 1 case with cancer involving RLN. Conclusions There were some causes of RLN injury. Exposure of RLN selectively,delicate operation and thyroid gland surgery specialist were the key point for prevention of the injury of RLN. Once RLN injury occured ,repairing should be performed as soon as possible.