摘要
目的甲状腺术中观察喉返神经与甲状腺下动脉的关系，探讨避免因显露而造成医源性喉返神经损伤的预防措施。方法回顾分析昆明医学院第一附属医院胃肠与甲状腺外科1998年1月至2006年12月收治同时显露双侧喉返神经的1642例甲状腺手术的病历资料。结果所有患者均成功显露双侧喉返神经，发现右侧2条“非返性喉返神经”。左侧喉返神经主干位于甲状腺下动脉之前、之后和动脉分叉之间的比例分别为27．2％（446／1642）、41．7％（684／1642）和31．2％（512／1642）；右侧分别为20．2％（331／1642）、43．4％（712／1642）和36．4％（597／1642）。医源性损伤8例，永久性损伤3例，暂时性损伤5例。神经减压11例，半年内神经功能恢复7例。结论尽管喉返神经与甲状腺下动脉的关系不恒定，但经验丰富、熟悉喉返神经解剖特点的医师，术中耐心的显露辨认和保护可避免喉返神经的医源性损伤。
Objective To study the anatomical relationship between the recurrent laryngeal nerves （RLN） and the inferior thyroid artery and to investigate measures on how to avoid iatrogenic injuries while expo- sing RLN during thyroid operation. Methods The clinical data of 1 642 patients undergoing thyroid operation with bilateral RLNs exposure from Jan. 1998 to Dee. 2006 were retrospectively reviewed. Results All RLNs were successfully exposed （including 2 non-recurrent laryngeal nerves on the fight side）. On the left side, the nerve passed anterior to the artery in 27.2% （446/1 642）, posterior to it in 41.7% （684/1 642）, and between the branches of the artery in 31.2% （512/1 642）. On the right side, the nerve was found anterior to the artery in 20.2% （331/1 642） , posterior to it in 43.4% （712/1 642）, and between the branches in 36.4% （597/ 1 642 ）. 8 nerves were iatrogenically injured, 5 were temporarily injured and 3 were permanently injured. Within half years, 11 nerves were decompressed and 7 cases recovered. Conclusion Although the anatomical relation- ship between RLN and the inferior thyroid artery is variable, iatrogenic injuries of the nerves can be avoided by nerves exposure.
出处
《中华内分泌外科杂志》
CAS
2012年第1期42-45,共4页
Chinese Journal of Endocrine Surgery
关键词
喉返神经
解剖
甲状腺切除术
医源性损伤
Recurrent laryngeal nerves
Anatomy
Thyroideetomy
Iatrogenic injury
