甲状腺手术致喉返神经损伤的分析及治疗探究

Analysis and treatment explore of recurrent laryngeal nerve injury caused by thyroid surgery

目的探讨甲状腺手术患者术后出现喉返神经损伤的原因及治疗措施。方法选取收治的各类甲状腺疾病患者215例,所有患者均具有手术指征。采用随机分组法将患者分为对照组(105例)和观察组(110例)。对照组患者采用传统未显露喉返神经方式进行手术,观察组患者采用显露喉返神经方式进行手术。两组患者手术治疗后均获10个月以上随访,针对两组患者手术后发生喉返神经损伤的情况及损伤恢复的情况进行回顾性对比分析。结果两组患者手术均获成功,但观察组患者术后发生喉返神经损伤情况明显低于对照组,两组结果比较差异有统计学意义(P<0.01)。通过随访结果显示,观察组患者术后喉返神经恢复情况也显著优于对照组,两组比较差异有统计学意义(P<0.05)。结论手术方式对进行甲状腺手术患者术后是否出现喉返神经损伤具有重要的影响。术中对喉返神经进行合理地显露,可对其起到显著的保护作用,降低损伤的发生,有效提高患者的手术质量及治疗效果。

Objective To investigate and analysis the causes and treatment measures of the pa- tients who occurred recurrent laryngeal nerve injury after thyroid surgery. Methods Select 215 thyroid disease patients who were treated in our hospital from March 2010 to December 2011. All the patients had surgical indications. The patients were divided into two groups using randomized methods： 105 cases of the control group and 110 cases of the study group. The control group was treated with traditional surgery meth- ods which didn＇ t reveal recurrent laryngeal nerve, while the study group patients revealed recurrent larynge- al nerve during surgery. All the patients acquired over 10 months＇ follow-up after surgery. Retrospective comparative analysis was conducted about the incidence rate of recurrent laryngeal nerve injury and recovery rate of recurrent laryngeal nerve between the two groups. Results The surgery of the two groups were suc- cessful, but the incidence rate of study group patients with postoperative recurrent laryngeal nerve injury was significantly lower than th~ control group, and the difference was statistically significant （ P 〈 0. 01 ）. Fol- low-up results showed that the recovery situations of the study group patients with postoperative recurrent la- ryngeal nerve were significantly better than the control group, and the difference was statistically significant （ P 〈 0. 05）. Conclusions The surgical method has important influence in patients undergoing thyroid surgery and occurring postoperative recurrent laryngeal nerve injury. Taking reasonable exposure to recurrent laryngeal nerve intraoperative can play a significant protective effect, reduce the incidence of injury and improve the patients＇ surgery quality and treatment effect.