甲状腺切除术中显露喉返神经的临床意义

The Value of Exposure of the Recurrent Laryngeal Nerve in Thyroidectomy

目的探讨在甲状腺切除术中解剖显露喉返神经的临床价值。方法回顾性分析2011年4月~2013年12月我院行甲状腺切除术377例患者的临床资料,其中术中显露喉返神经组218例和非显露喉返神经组159例,比较分析两组方法对术中避免喉返神经损伤的保护效果。结果所有患者随访至少9个月以上。显露喉返神经组术后出现喉返神经暂时性损伤2例,损伤率为0.92%;非显露喉返神经组术后出现喉返神经暂时性损伤6例,永久性损伤2例,损伤率为5.03%。两组喉返神经损伤率比较差异有统计学意义（P〈0.05）。结论甲状腺切除术中解剖显露喉返神经是安全可行的,是避免医源性损伤的有效方法。

Objective To explore the clinical value of exposure of the recurrent laryngeal nerve（ RLN） in thyroid surgery. Methods The clinical data of 377 cases who received thyroidectomy were retrospectively analyzed. During the surgery,the 218 patients received RLN exposure were regarded as RLN exposed group,and the rest 159 cases were as RLN unexposed group. Injuries of the RLN were compared between two groups. Results All cases were followed up more than 9 months. There were 2 cases of temporary RLN injury in the RLN exposed group,and the RLN injury rate was 0. 92 %. However there were 6 cases of temporary RLN injury and 2 cases of permanent RLN injury in the RLN unexposed group,and the RLN injury rate was 5. 0 3 %. There was statistical difference between the two groups（ P〈0. 05）. Conclusion The RLN exposure is a safe,feasible and effective method to prevent the iatrogenic RLN injury in thyroidectomy.