甲状腺手术喉返神经损伤规律及治疗分析.docVIP

精品论文 参考文献 甲状腺手术喉返神经损伤规律及治疗分析 怀化市第二人民医院头颈五官科 湖南怀化 418000 【摘 要】目的：分析甲状腺手术喉返神经损伤规律及治疗方法。方法：回顾性分析67例甲状腺手术喉返神经损伤患者的临床资料，其中46例患者采取喉返神经探查，其中22例患者出现缝线结扎或瘫痕粘连压迫喉返神经，并采取喉返神经减压术治疗；另外21例患者单纯采取保守治疗；分析喉返神经的缝线结扎、瘫痕粘连压迫损伤及喉返神经切断损伤情况，并对比所有患者治疗前后的嗓音声学分析结果、喉神经电生理学检查结果。结果：46例甲状腺手术喉返神经损伤患者经喉返神经探查后，喉返神经被缝线结扎17例，占36.96%；瘫痕粘连压迫损伤5例，占10.87%；喉返神经切断损伤24例，占52.17%；损伤部位：近环甲关节处34例，占73.91%；甲状腺中下部12例，占26.09%；治疗后，手术治疗组的Jitter、Shimmer、NNE均小于保守治疗组，经T检验，差异具有统计学意义（P＜0.05）；治疗后，手术治疗组诱发电位大于保守治疗组，经T检验，差异具有统计学意义（P＜0.05）。结论：喉返神经探查有利于了解甲状腺手术喉返神经损伤规律，采取喉返神经减压术治疗，对于恢复声带运动功能具有积极作用，值得临床推广使用。 【关键词】甲状腺手术；喉返神经损伤；喉返神经减压术 Thyroid surgery and the treatment of recurrent laryngeal nerve injury law YangZhipeng Huaihua City Second Peoples Hospital ENT Head and Neck HunanHuaihua 418000 [Abstract] Objective：To analyze the law of recurrent laryngeal nerve injury in thyroid surgery and treatment.Methods：We retrospectively analyzed the clinical data of 67 cases of thyroid surgery in patients with recurrent laryngeal nerve injury，which take 46 patients recurrent laryngeal nerve exploration，which appear suture ligation or scar adhesions 22 patients with recurrent laryngeal nerve，recurrent laryngeal nerve and take decompression treatment；an additional 21 patients were treated conservatively alone；analysis of the recurrent laryngeal nerve suture ligation，scar adhesions compression injury and denervation injury and compared before and after treatment，all patients voice acoustic analysis results laryngeal nerve electrophysiological findings.Results：46 cases of thyroid surgery in patients with recurrent laryngeal nerve injury after recurrent laryngeal nerve exploration，is the recurrent laryngeal nerve suture ligation in 17 cases，accounting for 36.96%；scar adhesions compression injury in 5 cases，accounting for 10.87%；24 injury denervation cases，accounting for 52.17%；injury site：near the cricothyroid joints in 34 cases，accounting for 73.91%；thyroid in the lower part of 12 cases，accounting for 26.09%；after treatment，Jitter surgery gro