【摘要】 目的:探索甲状腺手术后喉返神经损伤的预防及失误处理的有效方法。方法:回顾性分析236例甲状腺肿瘤行手术治疗患者的临床资料,总结喉返神经损伤的主要原因、损伤的预防及失误处理方法。结果:236例甲状腺肿瘤患者中,喉返神经总的损伤率为5.1%(12例),其中永久性损伤2例(0.8%),均为喉返神经离断伤;暂时性损伤10例(4.2%)。损伤原因依次为:操作不熟练致使解剖层次不清5例(2.1%),助手配合失当3例(1.3%),术野止血不彻底致使视野不清2例(0.8%),止血慌乱误伤1例(0.4%),切口过小使过度牵拉1例(0.4%);不同术式的损伤发生率也有所不同。结论:喉返神经损伤仍是甲状腺肿瘤切除中的常见并发症;正确选择术式、熟练而规范的操作、术者间默契的配合仍是预防的关键。更多还原

【Abstract】 Objective: To investigate the causes and treatment of recurrent laryngeal nerve(RLN) injury during the operation of thyroidectomy in patients with cancer of thyroid. Methods: Clinical data of 236 patients undergone thyroidectomy operation were reviewed. Results: No patient died while operation and staying in hospital. There were 12 cases of RLN injury,2 case of permanence RLN injury and 10 cases of caducity.5 cases (2.1%) were injured because of no stratification dissection; 3 cases (1.3%) were injured because of not collaborating well, and 2 cases (0.8%) were injured because of hurried and confused operation while bleeding. Conclusion: RLN injuries caused by mechanical injury during thyroid surgery is important. Delicate peration with gravity are the key point for prevention of the injury of RLN.更多还原