喉返神经显露在甲状腺手术中的临床意义

目的：通过对甲状腺手术喉返神经显露组与非显露组神经损伤差异的对比研究,探讨手术中显露喉返神经对预防和减少喉返神经损伤的意义。方法：回顾218例甲状腺手术患者的临床资料,共行300侧手术,172侧手术显露喉返神经,128侧未显露。结果：喉返神经损伤23例（侧）,手术侧损伤率为7.7%（23/300）,永久性损伤率为0%。显露组损伤率2.3%（4/172）显著低于非显露组14.8%（19/128）（P〈0.05）。行甲状腺部分切除、大部切除、侧叶次全切除及侧叶切除者喉返神经损伤率依次增高,且非显露组高于显露组,差异有统计学意义（P〈0.05）。结论：术中常规显露喉返神经在一定程度上可以减少或避免神经的损伤。

Necessity of exposing recurrent laryngeal nerve in thyroidectomy

Objective： To explore necessity of exposing recurrent laryngeal nerve in thyroidectomy,through comparing the differences of nerve injury in the nerves exposure and non- exposure groups. Methods： To review retrospectively the clinical data of 218 thyroidectomy patients. There were 300 unilateral procedures with nerves were exposed in 172 procedures,unexposed in 128 procedures. Results： The overall incidence of recurrent laryngeal nerve injury was 7. 7%（ 23 /300）,and with an inci dence of 0 % for permanent damage. The injury incidence in the nerves exposure and non- exposure groups was 2. 3 %（ 4 /172） and 14. 8%（ 19 /128） respectively,the difference was significant between the two groups（ P〈0. 05）. The injury rate of nerves at risk for partial lobectomy,most lobectomy,subtotal lobectomy and lobectomy was increased in that order,and the incidence was higher in non- exposure group than in exposure group,with statistical significance（ P〈0. 05）. Conclusion： The occurrence of recurrent laryngel nerve injury can be reduced or avoided by its careful exposure and identification during thyroid operation.