精细被膜解剖法在甲状腺手术中预防喉返神经与甲状旁腺损伤的应用

Application of Fine Membrane Anatomy in Preventing Recurrent Laryngeal Nerve and Parathyroid Injury in Thyroid Surgery

目的分析精细被膜解剖法在甲状腺手术中预防喉返神经与甲状旁腺损伤的效果。方法方便选择该院自2015年3月—2017年5月收治的115例行甲状腺手术患者,将其随机分为2组。对照组57例给予传统手术方式,观察组58例患者在手术中采用精细被膜解剖法,对比两组患者喉返神经、甲状旁腺损伤情况。结果观察组暂时性喉返神经损伤、永久性喉返神经损伤及甲状旁腺损伤的与对照组对比,前者均明显低于后者(P<0.05),观察组患者暂时性喉返神经损伤、永久性喉返神经损伤占比分别均是为1.72%,没有患者出现甲状旁腺损伤情况。观察组患者血钙水平为(2.37±0.36)mmol/L明显高于对照组(1.79±0.48)mmol/L,相对比(P<0.05)。观察组低钙血症发生率为1.72%(1/58)明显低于对照组7.02%(4/57),相对比差异有统计学意义(P<0.05)。结论对于行甲状腺手术者,在操作过程中采用精细被膜解剖法,可使喉上、喉返神经的损伤机率降低,将甲状旁腺及其滋养血管进行保留,值得在临床上使用。

Objective This paper tries to analyze the effect of fine membrane anatomy in preventing recurrent laryngeal nerve and parathyroid injury during thyroid surgery. Methods A total of 115 patients undergoing thyroid surgery treated in this hospital from March 2015 to May 2017 were convenient selected divided into two groups. 57 cases in the control group were given traditional surgical method. 58 patients in the observation group were treated with fine membranous anatomy,and the recurrent laryngeal nerve and parathyroid injury were compared between the two groups. Results The patients in the observation group had transient recurrent laryngeal nerve injury, permanent recurrent laryngeal nerve injury and parathyroid injury, significantly lower than the control group（P0.05）, the observation group of patients with temporary recurrent laryngeal nerve injury and permanent recurrent laryngeal nerve injury was 1.72%, no patients with parathyroid injury. The level of serum calcium in the observation group was（2.37 ±0.36）mmol/L, which was significantly higher than that in the control group of（1.79±0.48）mmol/L.The difference was statistically significant（P0.05）. The incidence of hypocalcemia in the observation group was 1.72%（1/58）, which was significantly lower than that in the control group of 7.02%（4/57）（ P 0.05）.Conclusion For thyroid surgery, the operation of fine membrane anatomy can reduce the probability of throat, recurrent laryngeal nerve damage, retain parathyroid and its nourishing blood vessels, so it is worthy of clinical use.