甲状腺再次手术中解剖显露喉返神经的临床意义

The contribution of exploring recurrent laryngeal nerve in thyroid gland reoperation

目的:探讨在甲状腺再次手术中解剖显露喉返神经与神经损伤的关系。方法:对232例甲状腺再次手术患者分两组,未解剖显露组110例,其中甲状腺癌76例,良性甲状腺疾病54例;解剖显露组102例,其中甲状腺癌70例,良性甲状腺疾病32例。结果:在甲状腺癌中未解剖组喉返神经损伤16例,损伤率为21.1%;解剖组喉返神经损伤2例,损伤率为2.9%;两者之间差异有统计学意义(P<0.05)。在良性甲状腺病中,未解剖组喉返神经损伤6例,损伤率为11.1%;解剖组喉返神经损伤0例,损伤率为0;两者之间差异有统计学意义(P<0.05)。结论:甲状腺再次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 analyze the relationship between exploring recurrent laryngeal nerve（RNL） and nerve injury in reoperation of thyroid gland.Methods：In this retrospectively reviewed,232 cases of thyroid reoperation were randomly divided into groups： RLN was not exposed in 110 cases（thyroid carcinoma 76,innocence tumor 54） and exposed for monitoring in 102 cases（thyroid carcinoma 70,innocence tumor 32）.Results：To thyroid carcinoma,16 cases（21.1%） suffered from RLN injury in no exposed group and 2 cases（2.9%） suffer from RLN injury in exposed group（P0.05）.To innocence thyroid tumor 6 cases（11.1%） suffered from RLN injury in no exposed group and 0 cases suffer from RLN injury in exposed group（P0.05）.The difference had statistical significance.Conclusion：Exploring RLN can lower nerve injury in thyroid reoperation,especially to thyroid cancer.