甲状腺术中不同方法预防喉返神经损伤的临床观察

目的探讨甲状腺术中预防喉返神经损伤的方法。方法回顾性分析2008年8月至2011年6月甲状腺术中应用显露喉返神经方法预防喉返神经损伤的430例临床资料(显露组),与同期应用传统方法预防喉返神经损伤的400例临床资料(对照组)进行对比研究,统计分析两组间喉返神经损伤的发生率。结果显露组发生永久性喉返神经损伤0例(0.0%),暂时性喉返神经损伤5例(1.25%),对照组发生永久性喉返神经损伤6例(1.50%),暂时性喉返神经损伤7例(1.75%),两组比较,永久性喉返神经损伤发生率差异有统计学意义(P<0.001);而暂时性喉返神经损伤发生率差异无统计学意义(P=0.426)。结论显露喉返神经是甲状腺术中预防喉返神经永久性损伤的可靠方法。

Comparative study on the effect of different approachs for preventing injury of recurrent laryngeal nerve in thyroidectomy.

Objective To explore the approaches to prevent injury of recurrent laryngeal nerve (RLN) in thyroidectomy. Methods The clinical data of 430 patients (the study group) with exposing RLN to prevent RLN damage in thyroidectomy from August 2008 to June 2011 was retrospectively analyzed, and compared with that of 400 patients (the control group) with traditional methods to prevent RLN damage during the same period. The incidences of RLN injury were compared between the two groups. Results There were no permanent RLN injury (0 case, 0.0%) and five cases (1.2%) with transient RLN injury in the study group. There are six cases (1.5%) with permanent RLN injury and seven cases (1.8%) with transient RLN injury in the control group. The ratio of permanent RLN injury showed statistically significant difference between the two groups (P<0.001). However, the ratio of transient RLN injury showed no statistically significant difference between the two groups (P=0.426). Conclusion It is a reliable method to apply exposing RLN to prevent RLNs from injury in Thyroidectomy.