甲状腺腺叶切除术中喉返神经入喉处解剖暴露的临床效果

CLINICAL EFFECT OF ANATOMICAL EXPOSURE OF RECURRENT LARYNGEAL NERVE DURING THYROID GLAND LOBECTOMY

目的探讨甲状腺腺叶切除术中喉返神经入喉处解剖暴露的临床效果。方法抽样选取104例行甲状腺腺叶切除术的病例作为研究对象,并随机均分为两组,一组予以喉返神经入喉处解剖暴露(实验组),另一组予以甲状腺下动脉下方解剖暴露(对照组),术后观察分析两组患者的临床效果。结果两组患者喉返神经损伤的发生率相较无显著性差异(p>0.05)。但在手术时间、术中失血量两个方面,实验组显然更具优势,且差异有统计学意义(p<0.01)。对照组患者术后VAS评分为(4.3±2.1)分,明显高于实验组的(2.1±1.0)分,组间对比具有统计学意义,p<0.05;实验组患者术后满意度为96.15%,明显高于对照组患者的82.69%,p<0.05。结论喉返神经入喉处解剖暴露,对于甲状腺腺叶切除术患者而言,其喉返神经损伤率低、手术时间短、术中失血量少,是一种较为实用的医疗方案,值得推广。

Objective To study the clinical effect of anatomical laryngeal exposure during thyroid gland lobectomy. Methods 104 cases of thyroid gland lobectomy were selected as the research object,and randomly divided into experimental group and control group： in the former group,anatomical exposure of recurrent laryngeal nerve was anatomically exposed at the laryngeal entrence during the lobectomy; in the latter,the inferior thyroid artery was exposed. The clinical effect of both groups after surgery were then observed and analyzed. Results The incidence rate of two groups with injuries of the recurrent laryngeal nerve was insignificantly different（ P〈0.05）. But in terms of operation time and intraoperative blood loss,the experimental group had more advantages with statistically significance as compared to the control group（ p〈0. 01）. Conclusion For patients with thyroid lobectomy,anatomical exposure of recurrent laryngeal nerve at the enterence of throat is superior for reduced incidence of laryngeal recurrent nerve injury. shorter operation time and less intraoperative blood loss. Therefore it is a practical approach worth promoting.