【摘要】 目的探讨甲状腺术区喉返神经与甲状腺下动脉及分支的显微解剖关甲状腺手术中喉返神经保护提供解剖学参考。方法对69例(80侧)头颈肿瘤患者甲状腺区的喉返神经和甲状腺下动脉及分支进行显微解剖及观测。结果 38.0%(30/79)的喉返神经在入喉前分为前、后两支,59.5%(47/79)的甲状腺下动脉存在二级分支,40.5%(32/79)的甲状腺下动脉存在三级分支。51.9%(41/79)的甲状腺下动脉二、三级分支与喉返神经相夹持、勾绕或小段伴行,其中24.1%(19/79)的甲状腺下动脉二、三级分支发出明确与喉返神经相勾绕或平行伴行的分支直至入喉处。结论甲状腺下动脉二、三级分支于近入喉处与喉返神经解剖关系密切,是甲状腺手术中喉返神经损伤的主要责任血管。更多还原

【Abstract】 OBJECTIVE To study the microsurgicalanatomic relationship between the recurrent laryngeal nerve(RLN)and the inferior thyroid artery(ITA) and its branches,and to provide anatomic basis for the protection of the recurrent laryngeal nerve in the thyroid surgery.METHODS A total of 80(right=44,left=36)RLNs in 69 patients with head and neck tumors undergoing lobectomy or total thyroidectomy was included in this study.The RLNs,ITAs and its branches were dissected and measured in the region of thyroid surgery.RESULTS Thirty(38.0%)RLNs bifurcated before they entered the larynx.Bifurcations were more common on the right(46.5%)side than on the left side(27.8%);Forty seven(59.5%)ITAs had secondary branches and 32(40.5%)ITAs had tertiary branches.In 41(51.9%)sides,the secondary branches of the ITA and the RLN were temporarily accompanied or intermingled together.Specially,there were 19(24.1%)secondary or tertiary branches of ITA run parallel to the RLN or wound the RLN until it enter the larynx.CONCLUSION In the area of the nerve entering the larynx,the relationship of the RLN to the secondary or tertiary branches of the ITA was very close.These branches of the ITA may be the main responsible vessels for the injury of the RLN.更多还原