喉返神经显露在甲状腺手术中的应用价值分析

Analysis of the application value of recurrent laryngeal nerve exposure in thyroid surgery

目的探讨喉返神经显露在甲状腺手术中的应用价值。方法选择100例于2018年1月~2019年3月期间广东省中西医结合医院普外科拟收治的甲状腺占位性病例且施行甲状腺手术患者为研究对象,随机将其分为研究组与对照组,每组50例。对照组不常规显露喉返神经,研究组术中行喉返神经探查显露,观察比较两组手术时间、术中出血量、术后引流量、术后拔管时间及喉返神经损伤情况。结果研究组的手术时间多于对照组(P<0.05);研究组术中出血量、术后引流量、术后拔管时间和对照组没有明显差异(P>0.05);研究组无喉返神经损伤者,对照组有5例(10.00%)患者出现单侧喉返神经损伤,术后出现轻度声音嘶哑,但均于1~3个月后恢复正常,研究组的喉返神经损伤率明显低于对照组(P<0.05)。结论甲状腺术中行喉返神经显露可明显减少对喉返神经的损伤,虽然延长了手术时间,但是对术中出血量、术后引流量、术后拔管时间没有明显影响,有利于术后恢复。

Objective To investigate the value of laryngeal nerve exposure in thyroid surgery.Methods A total of 100 patients with thyroid space occupying who would get the general surgery in Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine during the period from January 2018 to January 2019 were enrolled in this study.The patients were randomly divided into study group and control group,50 cases in each group.In the control group,the recurrent laryngeal nerve was not routinely revealed.The recurrent laryngeal nerve exploration was revealed in the study group.The operation time,intraoperative blood loss,postoperative drainage,postoperative extubation time and recurrent laryngeal nerve injury were compared between the two groups.Results The operation time in the study group was longer than that in the control group(P<0.05).There was no significant difference in intraoperative blood loss,postoperative drainage volume,postoperative extubation time between the study group and the control group(P>0.05).There was no recurrent laryngeal nerve injury in the study group.Five patients(10.00%)had unilateral recurrent laryngeal nerve injury,and mild hoarseness occurred after operation,but all returned to normal after 1~3 months.The recurrent laryngeal nerve injury rate of the study group was significantly lower than that of the control group(P<0.05).Conclusion Recurrent laryngeal nerve exposure during thyroid surgery can significantly reduce the damage to recurrent laryngeal nerve.Although the operation time is prolonged,it has no significant effect on intraoperative blood loss,postoperative drainage volume and postoperative extubation time,which is conducive to postoperative recovery and worthy of clinical application.