甲状腺良性病变手术显露喉返神经指征的探讨

A study of laryngeal recurrent laryngeal nerve in the operation of benign thyroid lesions

目的对甲状腺良性病变患者手术中显露的喉返神经指征进行探讨。方法选自2013年11月～2014年10月在我院肿瘤外科中住院治疗的甲状腺良性病变患者300例,将其随机分两组,每组各150例。观察组采取常规暴露喉返神经的手术方式,对照组采取非暴露喉返神经的手术方式,记录两组患者手术治疗后的喉返神经受损情况及手术3个月后喉返神经受损恢复状况。结果观察组甲状腺良性病变患者的喉返神经受损概率为1.33%,低于对照组的6.00%（P〈0.05）;观察组喉返神经受损患者的恢复概率为100.00%,高于对照组的22.22%（P〈0.05）。两组甲状腺良性病变患者喉返神经受损的各项相关性原因无明显差异（P〉0.05）。结论在甲状腺良性病变患者的手术中,常规的显露喉返神经指征是大切或全切患者甲状腺的一侧叶,或患者的甲状腺肿物在患者甲状腺的中下极部位以及患者的甲状腺后背膜部位。通过治疗后,能够规避患者的喉返神经受损,保障患者的生命安全,在临床上有非常重大的影响力。

Objective To investigate the indication of recurrent laryngeal nerve in the operation of thyroid benign lesions.Methods From November 2013 to October 2014, 300 patients with benign thyroid disease who were hospitalized in our hospital were randomly divided into two groups, 150 cases in each group. The observation group was treated by routine exposure of recurrent laryngeal nerve, and the control group was treated with non exposure to recurrent laryngeal nerve,and the recurrent laryngeal nerve injury two groups of patients were recorded after operation, the recovery probability of recurrent laryngeal nerve injury was recorded three months after operation. Results The probability of recurrent laryngeal nerve injury in patients with thyroid benign lesion was 1.33%, which was lower than that of the control group（6.00%）（P〈0.05）, and the recovery probability of recurrent laryngeal nerve injury in the observation group was 100.00%,higher than that in control group（22.22%）（P〈0.05）. There was no significant difference between the two groups of patients with benign lesions of the larynx（P〉0.05）. Conclusion In the operation of patients with thyroid benign lesions,the routine exposure of recurrent laryngeal nerve is a part of the thyroid gland in patients with large or total resection of the thyroid gland, or patients with thyroid lesions in patients with the middle and lower parts of the patient＇s thyroid and thyroid. After treatment, to avoid the patient＇s recurrent laryngeal nerve injury, protect the patient＇s life and safety,has a very important influence in the clinic.