甲状腺手术中喉返神经损伤的预防

目的探讨甲状腺手术中喉返神经损伤的预防方法。方法回顾性分析816例甲状腺手术患者的临床资料,总结喉返神经损伤与手术方式及是否显露喉返神经之间的关系。其中显露喉返神经患者(显露组)437例;非显露喉返神经患者(非显露组)379例。结果喉返神经损伤显露组26例,非显露组22例。在甲状腺次全切除或全切除术中,永久性损伤显露组1例,非显露组7例,两组比较差异有统计学意义;在甲状腺部分切除术中,暂时性损伤显露组10例,非显露组2例,两组比较差异有统计学意义。结论甲状腺部分切除术中,宜行囊内切除,而不宜常规显露喉返神经,以减少暂时性损伤;甲状腺次全切除或全切除术中,宜常规显露喉返神经,以减少永久性损伤。

Prevention of recurrent laryngeal nerve injury in thyroid surgery

Objective To explore the prevention of recurrent laryngeal nerve (RLN) injury in thyroid surgery. Methods The clinical data of 816 cases underwent thyroid surgery from 1986 to 2005 were analysed. Results In subtotal and total thyroidectomy, RLN permanent injury occurred in exposure group in 1 case, and non-exposure group in 7 cases, there was significant difference between two groups. In partial thyroidectomy, RLN temporary injury occurred in exposure group in 10 cases, and non-exposure group in 2 cases, there was significant difference between two groups. Conclusion Exposure of RLN may avoid permanent injury in subtotal and total thyroidectomy, non-exposure of RLN may decrease temporary injury in partial thyroidectomy.