喉返神经显露与区域保护对喉返神经损伤的对比性研究

Exposure of recurrent laryngeal nerve and regional protection of recurrent laryngeal nerve injury of the comparative study

目的：探讨甲状腺手术中显露喉返神经与区域保护对喉返神经损伤的临床意义。方法：将342例甲状腺手术随机分成喉返神经显露组（Ⅰ组）和区域保护组（Ⅱ组），每组各171例。Ⅰ组在术中切断、结扎甲状腺峡部后，向上提起腺体，在其下背侧沿气管食管沟向甲状软骨下角方向游离，显露喉返神经。Ⅱ组在处理甲状腺下动脉前后2支时紧贴腺体结扎切断，不分离显露喉返神经。结果：Ⅰ组喉返神经损伤1例（0．58％）；Ⅱ组喉返神经损伤7例（4．09％）。结论：甲状腺手术中显露喉返神经对预防该神经损伤有重要意义。

Objective：To investigate the value of exposure of recurrent laryngeal nerve in operation and regional protection on the clini-cal significance of recurrent laryngeal nerve injury.Methods：342 cases of thyroid operation were randomly divided into exposure of recur-rent laryngeal nerve group （ groupⅠ） and regional protection group （ Group II） , 171 cases in each group.Cut off, in groupⅡ, intraop-erative ligation of isthmus of thyroid gland, bring up, in its back side along the tracheoesophageal groove to the inferior horn of thyroid car-tilage direction free, exposure of the recurrent laryngeal nerve.Group II in the treatment of inferior thyroid artery before and after the two branch close to the gland ligation, not revealed the separation of R LN.Results：1 cases of recurrent nerve injury group I （0.58%）;la-ryngeal recurrent nerve injury in 7 cases （4.09%） in groupⅡthroat.Conclusion：Exposure of recurrent laryngeal nerve in thyroid opera-tion to prevent the nerve injury should be important.