喉返神经显露技术在甲状腺手术中的应用

Efficacy of recurrent laryngeal nerve exposure in thyroid surgery

目的探讨显露喉返神经(RLN)技术在甲状腺手术中预防RLN损伤的作用。方法采用前瞻、随机、对照的研究方法,将符合入选标准甲状腺手术患者373例随机分成观察组和对照组。观察组(173例)显露RLN行甲状腺手术,对照组(200例)不显露RLN行甲状腺手术,比较两组RLN损伤的发生率和预后情况。结果观察组共显露RLN 198条,RLN损伤率为0.5%(1/198),6个月内功能恢复,对照组RLN损伤率为6.0%(12/200),其中4例6个月内部分功能恢复,8例永久性损伤,两组比较差异有统计学意义(P<0.05)。结论甲状腺手术中常规显露RLN径路能有效降低RLN损伤的发生率。

Objective To investigate the efficacy of recurrent laryngeal nerve （ RLN ） exposure in preventing RLN injury during thyroid surgery. Methods Using a prospective, randomized, controlled design, 373 patients scheduled to undergo thyroid surgery and met the inclusion criteria were randgmly divided into observation group and control group. The patients of the observation group （ 173 cases ） underwent thyroid surgery with RLN exposure, while the patients of the control group （200 cases ） underwent thyroid surgery without RLN exposure. The RLN injury rate and outcome of the two groups were compared. Results A total of 198 RLNs were exposed in observation group with the RLN injury rate of O. 5% （1/198）, and the nerve injury recovered within 6 months. The RLN injury rate of the control group was 6.0% （12/200）. Of the patients with RLN injury, 4 cases partially recovered within 6 months and 8 cases were permanent injury. There were significant differences of RLN injury between the two groups （ P 〈 0.05 ） . Conclusions The routine exposure of RLN pathway during thyroid surgery can effectively reduce the incidence of RLN injury.