甲状腺良性病变术中解剖喉返神经的意义
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龙锦 E-mail:longjin@mail.cmu.edu.cn

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Importance of recurrent laryngeal nerve dissection in surgery for benign thyroid diseases
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    摘要:

    目的:探讨甲状腺良性病变初次手术术中解剖喉返神经(RLN)的意义。
    方法: 回顾性分析同一医生施行的241例甲状腺良性病变病例,其中单侧腺叶全切除术159例,双侧腺叶全切除术82例。按术中是否解剖RLN分为两组,其中解剖组145例,非解剖组96例。按术中涉及的RLN数量计算两组RLN损伤发病率。分析两组暂时性和永久性RLN损伤发病率的差异。
    结果:解剖组和非解剖组的暂时性和永久性RLN损伤发病率为4.1%,0和5.4%,3.8%。两组暂时性RLN损伤发病率差异无统计学意义(P>0.05),而解剖组永久性RLN损伤发病率低于非解剖组(P<0.05)。
    结论:甲状腺良性病变术中解剖RLN可降低发生永久性RLN损伤的风险。建议在甲状腺良性病变行腺叶切除术术中常规解剖RLN。

    Abstract:

    Objective: To assess the value of laryngeal recurrent nerve (RLN) dissection during primary surgery for benign thyroid diseases.
    Methods: Two hundred and forty-one patients with benign thyroid disease who underwent surgery performed by the same surgeon were retrospectively analyzed. Of the patients, 159 cases had unilateral total lobectomy and 82 cases had bilateral total lobectomy. The patients were divided into dissection group (145 cases) and non-dissection group (96 cases) as to whether or not they had RLN dissection. The incidences of RLN injury of the two groups were counted according to the number of RLN at risk of injury during surgery, and the difference in temporary and permanent RLN injury rates between the two groups was analyzed.
    Results: The incidence rate of temporary and permanent RLN injury was 4.1% and 0 in the dissection group, and was 5.4 and 3.8% in the non-dissection group, respectively. The incidence rate of temporary RLN injury had no statistical difference between the two groups (P>0.05). The incidence rate of permanent RLN injury of the dissection group was lower than that of the non-dissection group, and this had statistical difference (P<0.05).
    Conclusions: RLN dissection during the operation for benign thyroid disease can reduce the risk of permanent RLN injury. Total lobectomy with routine RLN dissection is recommended as a basic procedure in surgery for benign thyroid diseases.

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龙锦|郭仁宣|刘洋|郭克建.甲状腺良性病变术中解剖喉返神经的意义[J].中国普通外科杂志,2011,20(11):1164-1167.
DOI:10.7659/j. issn.1005-6947.2011.11.003

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  • 收稿日期:2011-04-15
  • 最后修改日期:2011-10-08
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  • 在线发布日期: 2011-11-15