甲状腺手术中喉返神经的应用解剖研究

目的通过术中喉返神经的观察与测量为甲状腺手术术中喉返神经的定位和保护提供解剖学基础。方法通过术中观察和测量接受甲状腺手术病人的喉返神经的解剖特点及其＂区域解剖变异＂,总结预防喉返神经损伤的措施及保护技巧。结果勾绕动脉后上行的喉返神经多数（62.54%）位于气管外侧缘中下1/3的深面;左侧喉返神经与气管侧壁距离为（5.63±0.58）mm;右侧喉返神经距离为（6.47±0.98）mm。走行于甲状腺背侧叶的喉返神经大部分（63.96%）位于左右侧叶中内2/5。喉返神经分叉大部分（67.14%）位于甲状腺下极的后外下方与甲状腺下极水平距为（0.624±0.021）cm。结论熟悉喉返神经的解剖特点,有选择的进行喉返神经显露,掌握喉返神经的显露技巧,能够有效的预防喉返神经损伤的发生。

Applied clinical anatomic study on recurrent laryngeal nerve in thyroidectomy

Objective： To provide anatomic foundation for positioning and protecting recurrent laryngeal nerve in thyroidctomy.Methods： The traveling of recurrent laryngeal nerve,the feathers of branches and location relation with inferior thyroid artery were observed and measured.The location relation with important structure of thyroid were also observed and measured.Results： Recurrent laryngeal nerve majority（62.54%）lied on the mediate-under of the lateral of tracheal.The distance of the left recurrent laryngeal nerve and the lateral of tracheal was 5.63±0.58mm.The distance of the right recurrent laryngeal nerve and the lateral of tracheal was 6.47±0.98mm.Recurrent laryngeal nerve traveled through side leaves of thyroid.Recurrent laryngeal nerve majority（63.96%）lied on mediate-intercede 2/5 of side leaves of thyroid.The majority of bifurcation of recurrent laryngeal nerve（67.14%）lied on behind-outside-under of under extremes.The distance between bifurcation of recurrent laryngeal nerve and under extremeness of thyroid was 0.624±0.021cm.Conclusion： Knowing every visual angle anatomy of recurrent laryngeal is the important foundation to protect recurrent laryngeal nerve in thyroidctomy.