甲状腺手术中喉返神经解剖的临床观察

Anatomy of recurrent laryngeal nerve during thyroid surgery

目的:研究甲状腺手术中喉返神经的解剖特点。方法:回顾性分析307例甲状腺疾病患者的手术资料。结果:解剖暴露喉返神经342条(右侧184条,左侧158条),神经位于下动脉深面通过215条(62.9%),神经位于动脉浅面通过106条(31.0%),神经在动脉分支之间通过21条(7.5%)。喉返神经入喉前分支者203条(59.4%),未分支直接入喉者136条(39.8%)。有3例(0.9%)术中证实为一侧"非返性喉返神经"。所有患者术后均未出现永久性喉返神经麻痹。结论:甲状腺手术中对喉返神经精细解剖后加以保护,是预防喉返神经损伤的有效方法。

Objective： To study the anatomic characteristics of recurrent laryngeal nerve during thyroid surger- y. Method：A retrospective review of surgical data of 307 patients undertook thyroid surgery was conducted. Re- suit：Total 342 recurrent laryngeal nerves were identified during the surgery（184 on the right side,left 158）. 215 （62.9 %） nerves were deep to the inferior thyroid artery, 106 （31.0 %）were superficial to the artery, 21 （7.5 %） were between the arterial branches. A nerve bifurcation was found in 203（59. 4%）. None of nerve bifurcation was found in 136（39.8%）. 3（0.9%）were confirmed to hold non-recurrent laryngeal nerves during operations. No pa- tient showed permanent laryngeal recurrent nerve paralysis postoperatively. Conclusion：The careful dissection and protection of the recurrent laryngeal nerve was an effective method to prevent its injury during thyroid surgery.