甲状腺再次手术中甲状旁腺和喉返神经的保护

Protection of Parathyroid Glands and Laryngeal Recurrent Nerves During the Reoperation on Thyroid Glands

目的:探讨再次甲状腺手术中保留甲状旁腺和避免喉返神经损伤的有效方法。方法:回顾分析2005年1月—2010年3月收治的67例接受再次甲状腺手术的临床资料。结果:67例甲状腺再次手术中,出现不同程度喉返神经损伤7例,其中1例为永久性损伤。甲状旁腺功能减退3例,均为轻症。结论:甲状腺再次手术时,甲状旁腺的保护,关键在于手术时能够识别它们,并尽量保护它们的血供,尤其是在分离甲状腺上下极背侧时。为避免喉返神经损伤,显露喉返神经是必要的手术操作程序。

Objective：To explore the effective method to protect parathyroid glands from resection by mistake and avoid laryngeal recurrent nerve injury during reoperation on thyroid gland.Methods： Retrospective analysis of the clinical data of 67 cases underwent the second operation on thyroid glands from January 2005 to March 2010.Results： Among 67 cases underwent reoperation on thyroid gland,7 cases had recurrent laryngeal nerve injury,one of which was permanent,3 cases had slightly hypoparathyroidism.Conclusions： To protect parathyroid form injury,it is important to recognize them and to preserve their blood supply as much as possible,especially when separate the upper pole,the lower pole,and the dorsal of thyroid during the reoperation on thyroid glands.It is a necessary procedure to expose laryngeal recurrent nerve to avoid it injury.