甲状腺手术喉返神经损伤分析

Analysis of recurrent laryngeal nerve truama in surgical operation for thyroid lesions

摘要: 目的:探讨甲状腺手术所致喉返神经(recurrent laryngeal nerve,RLN)损伤的原因和预防措施。方法:对319例甲状腺病变的手术方法及RLN在术中是否被分离保护与RLN损伤的关系进行分析。结果:319例手术均获彻底切除。术后3例出现RLN暂时性损伤,无术后大出血及甲状腺危象发生。结论:RLN的解剖关系较为复杂,熟悉RLN的解剖和变异,在甲状腺手术中根据情况有选择地显露RLN是减少其损伤的关键。

Abstract: Objective: To explore the causes of recurrent laryngeal nerve (RLN) trauma due to operations for thyroid lesion and the preventive measures.Methods: The surgical procedures for thyroid lesion,the correlation between whether the recurrent laryngeal nerve was isolated and protected in the operation and the recurrent laryngeal nerve trauma were analyzed retrospectively.Results: Three hundred and nineteen patients received complete resection.Three cases presented temporary trauma of recurrent laryngeal nerve,and no postoperative hemorrhoea or thyroid crisis occurred.Conclusions: The anatomy of the recurrent laryngeal nerve is complicated.The key to reducing RLN trauma is to know well the anatomy and the variation of recurrent laryngealn nerve,and to reveal the recurrent laryngeal nerve accordingly in the surgical operation for thyroid lesions.