甲状腺手术显露喉返神经的意义

The Significance of exposure recurrent laryngeal nerves( RLN) during the procedure of thyreoidectomy

目的探讨甲状腺术中显露喉返神经(recurrentl aryngealnerve,RLN)对预防和减少喉返神经损伤的意义。方法回顾分析从2002年1月至2008年12月在我院手术治疗的760例甲状腺疾病的患者。在760例患者中,480术中未显露喉返神经,280例术中常规显露喉返神经,观察两组术后永久性喉返神经损伤和暂时性喉返神经损伤的发生率。结果 16例患者发生永久性喉返神经损伤,其中未显露喉返神经组和显露喉返神经组分别是13例和3例,(有显著性差异(P<0.05)。而暂时性喉返神经损伤发生率两组没有显著差异(P>0,05)。结论甲状腺手术中正确辨认并安全地解剖喉返神经可以预防喉返神经损伤,降低喉返神经的损伤率。

Objective To approach the clinical significance of anatomizing the recurrent laryngeal nerve（ RLN） in preventing the injury in theymid surgery. Methods 760 patients with thyroid disease underwent thyreoidectomy from January 2002 to December 2008. 480 CaSeS were Routine exposed of RLN during the procedure of thyreoidectomy and 280 cases were not exposed. the incidence rates of temporary RLN injuries and permanent RLN injures were compared in two groups. Results 16cases occuried permanent RLN injuries total. 3 casesand 11 cases in group 1 and group 2 respectively occurred RLN injuries. It has notable difference,（ P 0. 05）. But there was not notable difference in the rate of temporary RLN injuries（ P 0. 05） in two groups. Conclusion Injury can be reduced by revealing RLN in thyroid surgery Skilled graspen anatomy characteristic of RLN and correct identification of RLN were essential in thyroid surgery.