良性甲状腺肿瘤手术损伤喉返神经的影响因素及预防措施

Factors Benign Thyroid tumors and Prevention of Recurrent Laryngeal Nerve Injury

目的探讨良性甲状腺肿瘤手术时损伤喉返神经的影响因素及预防措施。方法选取2014年4月至2015年4月在阜新市中心医院进行良性甲状腺肿瘤手术治疗的患者76例为研究对象,分析手术方式、暴露喉返神经与喉返神经损伤之间的关系,并分析有效的预防措施。结果手术部位、手术次数、神经暴露等因素对喉返神经损伤具有明显影响,其中右侧手术、再次手术及喉返神经不暴露时喉返神经损伤的发生率高于左侧手术、初次手术和喉返神经暴露患者,差异均有统计学意义(均P<0.05)。结论喉返神经损伤的主要原因是右侧手术、再次手术、非神经暴露等,治疗时暴露喉返神经,在视野保护下操作能降低喉返神经损伤的发生率。

Objective To study the analysis of benign thyroid tumor surgery for the treatment of laryngeal recurrent nerve injury causes and preventive measures.Methods Choose from April 2014 to April 2015 in Fuxin city center hospital for treatment of benign thyroid tumors in 76 patients for the study,retrospective analysis of the operation mode,expose laryngeal recurrent nerve and the relationship of the laryngeal recurrent nerve injury and effective preventive measures are analyzed.Results Surgical site,surgical times,nerve exposure and other factors have significant impact on the recurrent laryngeal nerve injury,in which the right side of the surgery,the high incidence of recurrent laryngeal nerve injury during reoperation and not exposed to the left recurrent laryngeal nerve surgery,initial operation and throat Shuttle nerve exposed patients,the differences were statistically significant（P 〈0.05）.Conclusion The main cause of laryngeal recurrent nerve injury is on the right side of surgery,surgery,again not nerve exposure, such as treatment show laryngeal recurrent nerve,in the field of vision protection under operation can reduce the rate of laryngeal recurrent nerve injury.