甲状腺不同术式中显露喉返神经对于预防其损伤的临床研究

目的探讨甲状腺不同术式中显露喉返神经的应用价值,以及对于预防其损伤临床研究的必要性。方法将2010年3月—2014年2月该院实施的142例甲状腺手术患者,按照是否术中显露喉返神经分为解剖组（79例）及非解剖组（63例）,比较两组患者手术方式、手术时间、术后喉返神经损失情况、住院时间。结果解剖组的手术时间长于非解剖组（P〈0.05）;解剖组的术后喉返神经损失率低于非解剖组（P〈0.01）,其中解剖组采取甲状腺次全切除术与非解剖组的喉返神经损伤率比较,差异无统计学意义（P〉0.05）,而采取甲状腺全切除术时,其中解剖组喉返神经损伤率低于非解剖组（P〈0.01）。结论显露喉返神经在甲状腺手术中能够避免损伤,尤其是在甲状腺全切除术中时应常规显露喉返神经。

Clinical Study of Exposing the Recurrent Laryngeal Nerve for Preventing Its Injury in Different Thyroid Surgeries

Objective To investigate the application significance of exposing the recurrent laryngeal nerve in different thyroid surgeries, and its necessity for preventing the injury of the nerve in clinical research. Methods 142 patients underwent thyroid surgery in our hospital from March 2010 to February 2014 were divided into the anatomical group（79 cases） and the non-anatomical group（63 cases） according to whether the recurrent laryngeal nerve was exposed in the surgery. And the operation mode, duration of operation, postoperative recurrent laryngeal nerve injury and the length of stay were compared between the two groups. Results The duration of operation of the anatomical group was longer than that of the non-anatomical group（P0.05）; the rate of postoperative recurrent laryngeal nerve injury of the anatomical group was lower than that of the non-anatomical group（P0.01）; the difference was not statistically significant between the two groups in the rate of recurrent laryngeal nerve injury when taking subto-tal thyroidectomy（P 0.05） while the rate of recurrent laryngeal nerve injury of the anatomical group was lower than that of the non-anatomical group when taking total thyroidectomy（P 0.01）. Conclusion Exposing the recurrent laryngeal nerve in thyroid surgery can avoid the injury of the nerve, especially in total thyroidectomy the nerve should be exposed conventionally.