摘要
目的探讨甲状腺手术并发喉返神经损伤的原因,为制定预防喉返神经损伤临床策略提供依据。方法回顾性收集2017年1月—2019年1月行甲状腺手术患者120例临床资料,并根据手术方式将患者分为显露喉返神经组和未显露喉返神经组,每组60例,对两组患者术后发生喉返神经损伤情况进行统计学分析。收集患者术中喉返神变异情况、患者甲状腺手术次数以及患者甲状腺疾病性质的临床资料,并统计分析对喉返神经损伤的影响。结果喉返神经显露组患者神经损伤发生率明显低于未显露组,差异具有统计学意义(P<0.05)。有喉返神经解剖结构变异者喉返神经损伤发生率高于无变异者;初次行甲状腺手术者喉返神经损伤发生率低于两次及以上手术史者;且术中甲状腺恶性肿瘤者较甲状腺良性疾病者更易发生喉返神经损伤,差异均具有统计学意义(P<0.05)。结论甲状腺手术未显露喉返神经、喉返神经解剖变异、甲状腺手术次数较多及甲状腺疾病恶性性质是造成喉返神经损伤的重要原因。术中充分显露喉返神经解剖结构,可有效减少神经损伤发生率。
Objective To explore the causes of thyroid surgery complicated with recurrent laryngeal nerve injury,and to provide a basis for the development of clinical strategies to prevent recurrent laryngeal nerve injury.Methods The clinical data of 120 patients with thyroid surgery in our hospital from January 2017 to January 2019 were retrospectively collected.According to the surgical method,the patients were divided into the recurrent laryngeal nerve group and the unrecognized recurrent laryngeal nerve group,Sixty cases in each group.Statistical analysis was performed on the recurrent laryngeal nerve injury in the two groups.The clinical data of the patient s intraoperative laryngeal variability,the number of thyroid surgery and the nature of the patient s thyroid disease were collected,and the effects on the recurrent laryngeal nerve injury were statistically analyzed.Results The incidence of nerve injury in the recurrent laryngeal nerve exposed group was significantly lower than that in the unexposed group,P<0.05,the difference was statistically significant.The incidence of recurrent laryngeal nerve injury in patients with anatomical structure of the recurrent laryngeal nerve was higher than that of no mutation;the incidence of recurrent laryngeal nerve injury in the first thyroid surgery was lower than that of two or more surgical operations;and the intraoperative thyroid malignancy was more than the thyroid gland.Patients with benign diseases are less likely to have recurrent laryngeal nerve damage.P<0.05,the difference was statistically significant.Conclusion Thyroid surgery does not reveal the recurrent laryngeal nerve,anatomical variation of the recurrent laryngeal nerve,the number of thyroid surgery and the malignant nature of thyroid disease are important causes of recurrent laryngeal nerve injury.Fully revealing the anatomical structure of the recurrent laryngeal nerve during operation can effectively reduce the incidence of nerve injury.
作者
赵振军
陈荣军
ZHAO Zhengjun;CHEN Rongjun(Department of General Surgery,Dongguan Eighth People's Hospital;Department of General Surgery,Donghua Hospital in Dongguan,Donggua,Guangdong Province,523000,China)
出处
《吉林医药学院学报》
2020年第1期38-40,共3页
Journal of Jilin Medical University
关键词
甲状腺
喉返神经损伤
原因
thyroid
injury of the recurrent nerve
reason
