喉返神经解剖在全麻下甲状腺手术中的应用

The clinical application of exposure of recurrent laryngeal nerve in thyroid surgery under general anesthesia

目的探讨全麻下甲状腺手术中喉返神经(RLN)显露在预防喉返神经损伤中的作用。方法对手术治疗的甲状腺疾病患者389例进行回顾性分析,163例手术常规显露喉返神经,226例手术常规不显露喉返神经。结果显露喉返神经术式组喉返神经损伤2例(均为暂时性喉返神经损伤),占1.10%(2/182);不显露喉返神经术式者喉返神经损伤12例(暂时性喉返神经损伤7例,永久性喉返神经损伤5例),占5.30%(12/226)。两组之间的差异有统计学意义(P<0.05)。结论全麻下甲状腺手术中显露喉返神经可以降低喉返神经损伤的发生率。

Objective To study the effect of exposure of recurrent laryngeal nerve （ RLN ） in prevention of RLN injury during thyroid surgery under general anesthesia. Methods The clinical data of 389 patients who underwent thyroid operations under general anesthesia were retrospectively reviewed. The RLN was exposed in 163 cases and was not exposed in 226 cases. Results Two cases （ 1.10% ） suffered from temporary RLN injury in exposure group and 12 cases （5. 30% ） suffered from RLN injury in non-exposure group （ temporary nerve injury in 7 cases and permanent nerve injury in 5 cases ） （ P 〈 0. 05 ）. Conclusions Exposure of RLN can greatly decrease the RLN injury rate in thyroid surgery under general anesthesia.