甲状腺次全切除术中不同甲状腺动脉结扎方式对患者喉返神经和甲状旁腺功能的影响

Effect of Different Thyroid Artery Ligation Methods in Subtotal Thyroidectomy on Recurrent La-ryngeal Nerve and Parathyroid in Patients

【目的】探讨甲状腺次全切除术中甲状腺动脉的不同结扎方法对甲状旁腺及喉返神经功能的影响。【方法】选取100例行甲状腺次全切除术的甲状腺功能亢进（甲亢）患者，依据术中对甲状腺动脉处理方法分为分支组和主干组，每组50例，比较两组甲状旁腺及喉返神经损伤及恢复情况。【结果】分支组术后即出现甲状旁腺损伤5例（10．00％），主干组甲状旁腺损伤7例（14．00％），两组均无永久性损伤；分支组术后出现暂时性喉返神经损伤6例（12．00％）及永久性喉返神经损伤2例（4．00％），主干组分别是9例（18．00％）和4例（8．00％）；分支组术后甲状旁腺及喉返神经功能恢复情况均较主干组好（ P＜0．05）。【结论】甲状腺次全切除时分离并结扎甲状腺动脉分支比仅结扎主干有明显的优势，可有效减少对患者甲状旁腺及喉返神经的损伤。

[Objective] To explore the effect of different thyroid artery ligation methods in subtotal thyroidectomy on recurrent laryngeal nerve and parathyroid in patients .[Methods]Totally 100 patients wit hyperthyroidism undergoing sub-total thyroidectomy were chosen .According to thyroid artery treatment methods ,all patients were divided into branch group and trunk group with 50 patients in each group .Parathyroid and recurrent laryngeal nerve injury and recovery were compared between two groups .[Results] Parathyroid injury occurred in 5 patients（10 .00% ） of the branch group and 7 patients（14 .00% ） of the trunk group .No permanent injury was found in two groups .Temporary recurrent laryngeal nerve injury occurred in 6 patients（12 .00% ） of the branch group and 9 patients（18 .00% ） of the trunk group .Permanent recurrent laryngeal nerve injury occurred in 2 patients（4 .00% ） of the branch group and 4 patients（8 .00% ） of the trunk group .Postoperative recovery of parathyroid and recurrent laryngeal nerve in the branch group was better than that in the trunk group（ P〈0 .05） .[Conclusion]Compared with only ligating the trunk of thyroid artery ,the dissociating and liga-ting thyroid artery during subtotal thyroidectomy has a distinct advantage ,and can effectively reduce the injury of parathy-roid and recurrent laryngeal nerve .