甲状腺手术中喉返神经和喉上神经的保护

The preservation method of the recurrent laryngeal nerve and superior laryngeal nerve in the thyroid surgery

甲状腺手术造成喉神经损伤是困扰医患双方的难题。术中喉神经保护的重要性毋庸置疑。然而,各级医生对喉神经变异的识别、保护方法的选择,甚至显露技术的经验,参差不齐,缺乏指南及规范。改良传统的手术方式,放弃甲状腺囊内切除等盲目操作,进一步提高保护意识,全面掌握甲状腺术中喉神经解剖特征、手术理念、操作技巧,术中常规显露喉神经,辅助术中神经监测手段,可显著降低术后喉神经损伤发生率,提高手术安全性、彻底性。

The laryngeal nerve injury caused by thyroidectomy is a problem which puzzled both surgeons and patients. There is no doubt of the importance of intraoperative laryngeal nerve protection. However, the experience to identify variation of the laryngeal nerve, choose the right protection method timely, and even reveal the laryngeal nerve proficiently, is uneven among the doctors at different levels, who lack of the direction by guideline. Improving the traditional surgical approach, giving up the blind resection within the thyroid capsule, and further raising the preservation awareness, completely acquisiting the anatomical characteristics, surgical conception, operating techniques, routine exposing the laryngeal nerve, and assisting by secondary intraoperative neuromonitoring, can reduce the rate of postoperative laryngeal nerve injury significantly, and improve surgical safety and thoroughness.