甲状腺癌术中喉返神经损伤发生的原因及预防措施探讨

目的　探讨甲状腺癌手术过程中发生喉返神经损伤的原因及预防措施。 方法　对我院10年间187例甲状腺癌手术的临床资料进行回顾性分析，主要分析喉返神经损伤与术式、喉返神经在术中是否被分离保护的关系。结果　本组患者甲状腺切除术喉返神经损伤10例，发生率约为5.3%。所有病例术后均有声嘶，间接喉镜检查证实有单侧声带运动障碍。经严密观察随访，15例3月后发音恢复正常，间接喉镜检查声带运动正常，喉返神经暂时性损伤率为80%；3例严密观察随访6个月仍声带麻痹、声音嘶哑，间接喉镜检查声带运动障碍，喉返神经永久性性损伤率为20%。结论　甲状腺癌术后喉返神经损伤的发生主要与术式有关，多为暂时性损伤。手术者的经验和手术技巧是防止此类损伤的关键，术中明确找到喉返神经并加以保护，将会降低喉返神经损伤率，但并不能完全避免喉返神经损伤的发生。

Cause and preventive measure of recurrent laryngeal nerve injury during operation of thyroid cancer

Objective To investigate the cause and preventive measures of recurrent laryngeal nerve(RLN) injury during thyroid surgery in the treatment of malignant thyroid neoplasms.Methods One hundred and eighty-seven patients with malignant thyroid neoplasms were treated by surgery from January 1996 to January 2006.What the operative ways were associated with RLN injury and whether RLN exposed or not during operation were analyzed retospectively.Results A total of 187 of patients were received thyroid surgery.Of all...