摘要
目的探索利用超声刀行复发性结节性甲状腺肿手术中解剖并保护喉返神经,避免其损伤导致术后声嘶及呼吸困难等并发症发生。方法总结对比利用超声刀行复发性结节性甲状腺肿手术82例中解剖并保护喉返神经和未解剖喉返神经术后并发症的情况,评估两者预防喉返神经损伤的手术效果。结果 82例复发性结节性甲状腺肿手术中,解剖喉返神经有60例,出现术后声嘶1例,考虑电热伤引起,1周后声嘶恢复正常。未解剖喉返神经22例,其中出现声嘶并发症3例,出现声嘶的2例术后6个月内声嘶恢复正常,1例出现声嘶及呼吸困难,在住院期间需要气管切开,1周后拔管后呼吸困难缓解,术口愈合出院,半年后仍有声嘶,较出院时改善。手术中解剖并保护喉返神经与未解剖喉返神经出现的术后并发症相比有显著差异。结论利用超声刀行复发性结节性甲状腺肿手术中解剖并保护喉返神经,避免其损伤导致术后声嘶及呼吸困难等并发症发生是可行的。
Objective To study the surgical protocol for protecting recurrent laryngeal nerve during operation of recrndescent tuberculous struma avoiding the complication of hoarseness and dyspnea. Methods Summarize the situation of complications in 82 cases of recrudescent tuberculous struma operation, compare the situation of patients with ultrasonic - knife dissecting and protecting recurrent laryngeal nerve and that of those patients without doing this. Results In 82 patients, 60 cases had a surgical protocol that recurrent laryngeal nerve was exposed by ultrasonic - knife and then carefully protected, there is only one case experienced hoarseness due to thermal burning of ultrasonicknife to the nerve and restored a week later. In the other 22 cases without doing this surgical protocol 3 cases appeared to have side - effects of hoarseness. The recovery of hoarseness took six months in 2 cases. 1 case had experienced the breath difficulty and hoarseness after operation and need tracheotomy in hospitalization, the dyspnea released after tubedrawing a week later, incision healed but hoarseness lasted for half year, though improved, The situations of complication of the two groups had significant difference. Conclusion It is feasible in recrudescent tuberculous struma surgery by using ultrasonic - knife in lower position of thyroid with small cut and by exposing and protecting recurrent laryngeal nerve, showing remarkable effects in avoiding operation complication or side -effects.
出处
《现代医院》
2012年第3期41-42,共2页
Modern Hospitals
关键词
复发性结节性甲状腺肿手术
喉返神经
超声刀
Recrudescent tuberculous struma operation, Recurrent laryngeal nerve, Ultrasonic -knife
