甲状腺手术中喉返神经的显露与保护分析及治疗效果分析

Analysis of Exposure and Protection of Recurrent Laryngeal Nerve in the Thyroid Surgery and Analysis of Treatment Effect

目的研究甲状腺手术中喉返神经的显露与保护分析及治疗效果。方法该次研究选取的研究对象为2011年1月—2017年9月期间在该院进行治疗的甲状腺手术患者,将60例患者根据术中是否显露喉返神经分为对照组(常规手术30例)和观察组(显露喉返神经30例)。将两组甲状腺手术患者的手术时间、术中出血量、喉返神经损伤率、低钙血症发生率以及住院时间进行比对。结果观察组甲状腺手术患者的手术时间(132.54±8.97)min比对照组长(t=8.31,P=0.01),组间对比术中出血量(45.25±7.16)mL、喉返神经损伤率(0.00%)、低钙血症发生率(3.33%)、住院时间(6.85±1.79)d数据相近(t/χ~2=0.03、3.16、0.35、0.36,P=0.98、0.08、0.55、0.72)。结论甲状腺手术中喉返神经的显露有利于术中采取有效的保护措施,避免损伤喉返神经,可减少术后声音嘶哑、呼吸困难等不良情况的发生,适合推广应用在临床中。

Objective To research the exposure and protection of recurrent laryngeal nerve in the thyroid surgery and analysis of treatment effect. Methods 60 cases of patients with thyroid surgery in our hospital from January 2011 to September 2017 were selected as the research objects and divided into two groups with 30 cases in each according to whether the recurrent laryngeal nerve was exposed or not, and the control group and the observation group respectively used the routine surgery and recurrent laryngeal nerve exposure, and the operation time, intraoperative bleeding amount, injury rate of recurrent laryngeal nerve, incidence rate of hypocalcemia and length of stay were compared between the two groups. Results The operation time in the observation group was（132.54 ±8.97）min, which was longer than that in the control group（t=8.31,P=0.01）, and the differences in the intraoperative bleeding amount, injury rate of recurrent laryngeal nerve, incidence rate of hypocalcemia and length of stay between the two groups were similar, which were respectively（45.25±7.16）m L, 0.00%, 3.33%,（6.85±1.79）d,（t/χ^2=0.03,3.16,0.35,0.36,P=0.98,0.08,0.55,0.72）. Conclusion The effective protection measures of exposure of recurrent laryngeal nerve in the thyroid surgery can avoid the injury of recurrent laryngeal nerve and reduce the adverse reactions such as hoarseness and dyspnea, which is suitable for the clinical promotion and application.