甲状腺肿瘤手术喉返神经的损伤问题

On the Problem of Recurrent Laryngeal Nerve Happening During Operation for Thyoid Tumours

本文报告１５５７例涉及喉返神经的甲状腺肿瘤手术。术中提倡暴露喉返神经，但对于双侧或巨大肿瘤及甲状腺癌侵犯神经者，可区别对待。本组采用三个解剖标志寻找喉返神经，神经麻痹率：良性肿瘤与恶性肿瘤分别为２．３％和９．８％；首次手术与再次手术分别为３．９％和１０．５％。两组差异均有显著性（Ｐ＜０．０１）。术中发现误断神经应及时行神经吻合术，本组成功率为５５．５％（５／９）。

One fhousand five hundred and fifty seven patients with thyroid tumour involving recurrent larngeal nerve (RLN) are reported in the article. During operation,exposing RLN wasadvocated. However,implementation of such a recommendation varied with the bilateral,hugeand thyoid cancer that had the nerve invasion. In our series, three anatomic markers wereused to look for the RLN. The incidence of RLN palsy for benign and malignant tumors were2. 3 % and 9. 8% ;the primary and secondary operations were 3. 9% adn 10. 5% respectively,which showed statistically significant difference between them (P<0. 01). The nerve shouldbe anastomosed immediately after the nerve was found to be cut mistakenly during operation. The successful rate seen in this series was 55. 5 % (5/9).