甲状腺手术显露喉返神经的临床意义-普通外科学专业论文.docxVIP

汕头大学医学院硕士学位论文 汕头大学医学院硕士学位论文 汕头大学医学院硕士学位论文 汕头大学医学院硕士学位论文 I I PAGE PAGE II 中 文 摘 要 目的 探讨甲状腺手术中常规显露喉返神经对预防和减少喉返神经损伤的意义。 方法 选择 2010 年 1 月~2012 年 1 月期间在我院普外科(西七病区)行甲状腺手术患者的临床资 料进行回顾性分析，其中术中解剖显露喉返神经 105 例作为实验组，同时选择 43 例术中 未解剖显露喉返神经的患者作为对照组。从两组患者的年龄、性别、肿块性质、手术方式、 手术时间、术中出血量、住院天数、手术并发症以及喉返神经损伤等方面进行比较。 结果 实验组与对照组比较，两组患者的年龄、性别、肿块性质、手术方式、手术时间、术 中出血量、住院天数、手术并发症方面均无显著性差异（P 0.05）；术中解剖显露喉返神 经组(105 例)出现喉返神经损伤 1 例，总损伤率 0.95%；术中未解剖显露喉返神经组(43 例) 出现喉返神经损伤 3 例，总损伤率 6.97%；两组神经损伤率比较差异有统计学意义(P 0.05)。 结论 甲状腺手术中常规解剖显露喉返神经能显著降低喉返神经损伤的发生率。 关键词：甲状腺；手术；喉返神经 。 Abstract Objective To investigate the clinical value of preserving the recurrent laryngeal nerve during routine exposure of recurrent laryngeal nerve in thyroid surgery. Materials and methods 148 patients with thyroidectomy in Department of General Surgery of the Second Affiliated Hospital, Medical College of Shantou University from January 2010 to January 2012, were analyzed. 105 patients were exposed recurrent laryngeal nerve in thyroidectomy and 43 patients were not exposed recurrent laryngeal nerve routinely. The general situation of patients,such as sex, age, pathotype，the way of operation，time of operation, bleeding volume, hospital stay, postoperative complications and the incidences of injury to the nerve between the two groups, were compared respectively. Results No difference in the sex, age, pathotype，the way of operation, time of operation, bleeding volume, hospital stay, postoperative complications were seen between the two groups (P 0.05). Post-operative hoarseness was found in one case for exposed recurrent laryngeal nerve in thyroidectomy and three cases for not exposed recurrent laryngeal nerve in thyroidectomy. The incidences of injury to the nerve are 0.95% and 6.97%. The two groups were different in statistics((P 0.05). III III PAGE PAGE IV Conclusions Exposure of the recurrent laryngeal nerve may greatly reduce the incidence of injury to the nerve in surgical intervention of thyroid gland. Key words: T