甲状腺手术中显露喉返神经的意义

The clinical implication of exposure of recurrent laryngeal nerve in thyroid surgery

目的 探讨甲状腺手术中喉返神经显露的方法和利弊。方法 对 2148 例甲状腺切除术患者分两组进行前瞻性研究,其中术中显露喉返神经936例,不显露喉返神经1212例。结果 显露喉返神经术式者喉返神经损伤2例,损伤率为0 21%。不显露喉返神经术式者喉返神经损伤5例,损伤率为0 41%。两者之间差异有统计学意义(P<0 05)。结论 甲状腺全切除术中显露喉返神经可以降低喉返神经损伤的发生率。术中应先在甲状腺下动脉周围寻找喉返神经,然后在喉返神经入喉处或颈动脉鞘迷走神经附近寻找喉返神经。

Objective To study the methods and benefits of exposure of recurrent laryngeal nerve(RLN) in thyroid surgery Methods In this study, 2148 patients admitted in our hospital from July 1993 to July 2003 were divided randomly into two groups: RLN exposure group (936 cases) and RLN non exposure group (1212 cases) RLN was dissected around the inferior thyroid artery, thyroid cartilage, and cervical vagus Results Two cases (0 21%) suffered from RLN injury in exposure group and 5 cases (0 41%) suffered from RLN injury in non exposure group ( P <0 05) Conclusion The exposure of RLN greatly decreased RLN injury in thyroid surgery, especially in case of total lobectomy