喉返神经显露在甲状腺良性病变手术中的意义
作者:
通讯作者:
作者单位:

作者简介:

张社芹

基金项目:


The clinical implication of exposure of recurrent laryngeal nerve during operation for benign thyroid neoplasm
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 音频文件
  • |
  • 视频文件
    摘要:

    目的:探讨甲状腺良性病变手术中喉返神经(RLN)显露的临床效果。
    方法:将收治的768例甲状腺良性病变患者按手术序号随机分为3组:(1)选择性显露RLN组(选择组,单号根据患者术中情况显露RLN者), 106例,即行腺叶全切、背侧腺体不能保留的腺叶次全切或再次手术者RLN选择显露;(2)选择非显露组(非显露组,单号术中不显露RLN者), 278例;(3) 常规显露组(常规组,双号术中RLN常规显露),384例。
    结果:全组RLN损伤率1.04%(8/768),无永久性损伤和双侧损伤。RLN非显露组损伤率0.72%(2/278),选择组0.94%(1/106),常规组1.30%(5/384),3组间差异无统计学意义(P>0.05);非显露组手术时间(78.96±17.60)min,显著短于选择组的(89.05±18.50)min和常规组的(93.44±18.90)min(P<0.05);非显露组术中出血量(42.73±23.08)mL,显著少于选择组的(56.47±24.43)mL和常规组的(62.03±27.46)mL(P<0.05)。
    结论:在甲状腺良性病变手术中应根据患者情况决定是否显露RLN。

    Abstract:

    Objective:To explore the clinical effect of exposure of recurrent laryngeal nerve(RLN) during operation in patients with benign thyroid neoplasm.
    Methods :Seven hundred and sixty-eight patients with benign thyroid neoplasm admitted between July 2005 and June 2008 were randomly divided into three groups according to the operation procedure:(1) For patients with lobectomy or subtotal lobectomy, the dorsum of gland could not be retained or with reoperation,RLN was selectively exposured; (2) 278 cases with non-exposure of RLN; (3) 384 patients had routine exposure of RLN.
    Results:Of all the cases,the injury rate of RLN was 1.04% (8/768),no permanent injury or bilateral RLN injury ouarred.The injury rate of RLN in non-exposure groups was 0.72% (2/278), in selective explore groups and routine groups was 0.94%(1/106) and 1.30%(5/384),respectively,but the difference was not significant between the three groups(P>0.05). Operative procedure time was significantly shorter in non-exposure groups than that in selective group and routine group[(78.96±17.60)min vs. (89.05±18.50)min and (93.44±18.90)min,P<0.05].The bood loss during operation was significantly less in non-exposure group than that in selective group and routine group[(42.73±23.08)mL vs. (56.47±24.43)mL and (62.03±27.46)mL,P<0.05].
    Conclusions:Exposure and non-exposure of the RLN should be determined by the patient′s condition of benign thyroid neoplasm during operation.

    参考文献
    相似文献
    引证文献
引用本文

张社芹, 易文君, 李志群,凌峰.喉返神经显露在甲状腺良性病变手术中的意义[J].中国普通外科杂志,2009,18(5):13-486.
DOI:10.7659/j. issn.1005-6947.2009.05.013

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
历史
  • 收稿日期:
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2009-05-25