显露喉返神经在甲状腺切除术中的临床意义

目的探讨甲状腺手术中显露喉返神经对防止喉返神经损伤的价值。方法回顾性分析2 481例甲状腺手术患者的临床资料,其中术中显露喉返神经组1 425例和非显露喉返神经组1 056例,比较两组间并发喉返神经损伤的几率。结果显露喉返神经组喉返神经暂时性损伤31例,损伤率为2.18%,无永久损伤病例;非显露喉返神经组喉返神经损伤44例,损伤率为4.17%,其中暂时损伤39例,永久损伤为5例。两组喉返神经损伤率比较差异有统计学意义(P<0.01)。结论甲状腺手术术中显露喉返神经对保护喉返神经是安全和有效的,对预防或避免医源性喉返神经损伤有重要意义。

Exposure of the Recurrent Laryngeal Nerve in Thyroid Surgery

Objective To investigate the value of exposure of the recurrent laryngeal nerve （RLN） in thyroid surgery for the prevention of the RLN injury. Methods The clinical data of 2 481 cases with thyroid diseases undergoing thyroid surgery from January 2004 to December 2011 were retrospectively reviewed. The patients were divided into two groups： 1 425 cases had the recurrent laryngeal nerve exposed （RLN exposed group） and 1 056 cases unexposed the recurrent laryngeal nerve （RLN unexposed group）. Injuries of the RLN were observed. Results There were 31 cases （2.18%） of temporary nerve injuries in the RLN exposed group but no permanent nerve injury case was found. There were 39 cases of temporary nerve injuries and 5 ca- ses of permanent nerve injuries in the RLN unexposed group （4.17%）. There was significant difference be- tween the two groups （P 〈 0.01 ）. Conclusion Exposure of RLN in thyroid surgery is a safe and effective way to protect the RLN. It is very helpful to prevent the iatrogenic recurrent laryngeal nerve injury.