解剖喉返神经预防甲状腺术中神经损伤临床研究.docVIP

解剖喉返神经预防甲状腺术中神经损伤临床研究 　　[摘要]目的 探讨甲状腺次全切除和全切除术中解剖喉返神经降低喉返神经损伤概率的可行性。方法 选取2015年1月～2016年6月在我院普外科实施甲状腺手术404例患者，按照喉返神经解剖是否解剖分为解剖组（n=198）和未解剖组（n=206）。解剖?M采用解剖喉返神经，未解剖组不解剖喉返神经。比较两组术中、术后情况及喉返神经损伤率。结果 解剖组手术时间较未解剖组稍长[（80.30±5.32）min vs.（73.20±4.67）min，P0.05）。两组喉返神经损伤概率比较，差异有统计学意义（P0.05）。结论 甲状腺次全切除及全切除术中解剖喉返神经可显著降低喉返神经损伤的发生率。 　　[关键词]甲状腺；喉返神经；并发症 　　[中图分类号] R653.06 [文献标识码] A [文章编号] 1674-4721（2017）04（b）-0064-04 　　Clinical study on the dissection of recurrent laryngeal nerve in prevention of nerve injury during thyroid surgery 　　QUAN Yan GE Zi-hao XIE Shun-feng 　　Department of Thyroid and Breast Surgery，the First Affiliated Hospital of Shantou University Medical College，Guangdong Province，Shantou 515041，China 　　[Abstract]Objective To investigate the feasibility of reduction of the recurrent laryngeal nerve injury during subtotal and total thyroidectomy.Methods Altogether 404 cases of patients who underwent thyroid surgery in Department of General Surgery in our hospital from January 2015 to June 2016 were divided into anatomical group （n=198） and non-anatomical group （n=206） according to the anatomy of the recurrent laryngeal nerve.The recurrent laryngeal nerve was dissected in anatomical group；while，the recurrent laryngeal nerve of non-anatomical group was not dissected.The incidence of recurrent laryngeal nerve injury in two groups was compared intraoperatively and postoperatively.Results The duration of surgery of anatomical group was longer [（80.30±5.32） min vs. （73.20±4.67） min，P0.05）.The probability of recurrent laryngeal nerve injury between the two groups was statistically significant （P0.05）.Conclusion The anatomy of recurrent laryngeal nerve in subtotal thyroidectomy and total thyroidectomy can significantly reduce the injury of recurrent laryngeal nerve. 　　[Key words]Thyroid gland；Recurrent laryngeal nerve；Complication 　　甲状腺手术众多并发症中，喉返神经损伤是最常见且对患者生活质量影响较严重的并发症[1]，一直受外科医生的高度重视。常见的喉返神经损伤分为两型：一种为暂时性的喉返神经损伤，一般在术后3～6个月可恢复；另一种为永久性的喉返神经损伤，术后6个月仍不能完全恢复[2]。目前仍没有治疗喉返神经损