摘要
目的探讨喉返神经（RLN）肉眼下无损伤、连续性完整，术后仍发生声音嘶哑的原因和预防措施。方法回顾性分析2001年1月至2011年1月江苏省宿迁市人民医院1871例甲状腺手术的临床资料，包括显露RLN919例，其中同时显露双侧RLN757例；未显露RLN952例。结果常规手术方式和微创手术方式共显露1676支RLN，肉眼下均确认RLN无损伤或其连续性完整，但术后仍发生声音嘶哑19例，总发生率为2．12％（19／897）；未暴露RLN的声音嘶哑52例，总发生率为5．46％（52／952），2组比较差异有统计学意义（P〈0．05）。结论RLN肉眼下无损伤、连续性完整，不代表神经电生理无损伤；RLN损伤显露组明显低于未显露组；手术操作不当、热传导及术后疤痕粘连等是RLN肉眼下无损伤、连续性完整，术后仍发生声音嘶哑的主要原因；避免RLN损伤重在预防。
Objective To study the reasons and prevention of the hoarse voice after continuity-intact re- current laryngeal nerve（RLN） operation without damage of RLN under naked eyes. Methods Data of 1871 pa- tients undergoing thyroid surgery from Jan. 2001 to Jan. 2011 were retrospectly analyzed. 919 patients had their RLN exposed, among whom 757 patients had bilateral RLN exposed. 952 patients didn＇t have their RLN exposed in the surgery. Results A total of 1676 RLNs were exposed by the routine method and minimally invasive meth- od. All the nerves were confirmed no damage and continuity intact under naked eyes. Hoarse voice occurred to 19 patients after surgery, with the percentage of 2. 12% （19/897）. The rate of hoarse voice in the non-exposed group was 5.46% （52/952）. The difference of horse voice between the RLN exposed group and non-exposed group had statistical significance （ P 〈 0. 05 ）. Conclusions RLN without damage under naked eyes and continu- ity intact doesn＇t mean no damage of electroneurophysiology. The rate of RLN damage in the exposed group was less than that in the non-exposed group. The major causes of hoarse voice may include misoperation, heat conduc- tion and postoperative scar adhesion. The key to avoid RLN damage is prevention.
出处
《中华内分泌外科杂志》
CAS
2012年第6期401-403,共3页
Chinese Journal of Endocrine Surgery
关键词
喉返神经
肉眼下无损伤
连续性完整
声音嘶哑
Recurrent laryngeal nerve
No damage under naked eyes
Continuity intact
Hoarse voice
