摘要
目的：探讨困难甲状腺手术中喉返神经解剖的方法,以最大限度减少损伤,提高手术的安全性。方法：回顾性分析52例巨大结节性甲状腺肿、胸骨后结节性甲状腺肿、位于甲状腺下极的结节性甲状腺肿、甲状腺癌以及甲状旁腺肿瘤等困难甲状腺手术中喉返神经的解剖过程和方法,了解病变累及喉返神经的状况以及避免喉返神经损伤的措施。结果：52例患者中,除2例甲状腺癌一侧喉返神经受侵予以切除外,其余50例喉返神经均解剖成功。50例喉返神经解剖成功者中,3例喉返神经拉长者术后无声嘶,2例喉返神经局部压为扁平者术后也无声嘶,3例术后轻微声嘶者经营养神经治疗1~3个月后恢复正常。1例喉不返神经,2例胸骨劈开,2例术后行气管切开。术后无并发症发生。结论：困难甲状腺手术中喉返神经的解剖大多需要游离腺叶和肿瘤并将其翻向内前上方,再以气管食管沟、甲状腺下动脉和（或）甲状软骨下角为标志进行解剖,实践证明该方法可行。
Objective：To explore the methods of the larygeal recurrent nerve dissection in different and diffi- cult thyroid surgery,so as to minimize damage and improve the safety of the operation. Method： The process and methods in different laryngeal recurrent nerve dissection about 52 hospitalized patients from 2010 to 2012 were ret- rospectively analyzed. These cases include large nodular goiter, nodular goiter behind the sternum or located in the lower pole of the thyroid gland, thyroid cancer,tumors of parathyroid gland, etc. We studied the conditions of le- sions involving the laryngeal recurrent nerve and the defensive measures to protect the nerve. Result：The laryngeal recurrent nerve was dissected successfully in 50 cases, except 2 cases whose laryngeal recurrent nerve were violated by thyroid cancer. Conclusion：When we dissect the laryngeal recurrent nerves in different and difficult thyroid, the glands and tumors were mostly needed to be freed and turned inward and forward. After that,the laryngeal recur- rent nerves can be dissected successfully with the markers of tracheoesophageal groove, inferior thyroid artery and/or angle under the thyroid cartilage.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2014年第5期318-321,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
喉返神经
解剖
甲状腺
laryngeal recurrent nerve
dissection
thyroid gland
