作　　者： (唐巍）; (张显岚）; (曾繁余）;

机构地区： 桂林医学院附属医院普外科,广西桂林541000

出　　处： 《中国现代手术学杂志》 2017年第3期194-196,共3页

摘　　要： 目的探讨喉返神经入喉处解剖暴露在甲状腺腺叶切除术中的临床效果。方法回顾性分析我院2012年12月~2015年5月行甲状腺腺叶切除术的120例患者临床资料,依据术中喉返神经暴露方法分为两组,各60例,试验组采用喉返神经入喉处解剖暴露,对照组采用甲状腺下动脉下方解剖暴露。比较两组的手术时间、术中出血量、并发症发生情况以及术后疼痛VAS评分和患者满意度。结果试验组平均手术时间和术中出血量分别为(80.3±10.1)min和(34.5±10.2)ml,对照组分别为(115.8±12.3)min和(46.8±11.5)ml,组间比较均有统计学差异(P<0.05)。试验组并发症发生率为3.3%,明显低于对照组的16.7%(P<0.05)。试验组VAS评分平均(2.1±1.0)分,低于对照组的(4.3±2.1)分(P<0.05);试验组患者术后满意度为96.7%,高于对照组的83.3%,差异有统计学意义(P<0.05)。结论甲状腺腺叶切除术中喉返神经入喉处解剖暴露可以加快手术进程,减少并发症的发生,具有重要临床意义。 Objective To discuss the clinical effect of the entrance point exposure technique of the recurrent laryngeal nerve （RLN） during the thyroid lobectomy.Methods A total of 120 cases performed thyroid lobectomy in our hospital from December 2012 to May 2015 were retrospectively analyzed.According to the exposure technique of RLN,all cases were divided into two groups with 60 cases for each：The experimental group was carried out anatomical exposure of the entrance in throat of RLN,and the control group was exposed anatomically below the inferior thyroid artery.The operation time,intraoperative blood loss,postoperative complication rate,postoperative VAS score and satisfaction of patients was compared between two groups.Results The operation time and intraoperative blood loss was （80.3 ± 10.1）min and （34.5 ± 10.2） ml respectively in the experimental group,and （115.8 ± 12.3） min and （46.8 ± 11.5） ml respectively in the control group.There was statistical difference in operation time and intraoperative blood loss between two groups （P 〈0.05）.The postoperative complication rate of experimental group was 3.3%,and was lower than 16.7% of control group （P 〈 0.05）.The VAS score was （2.1 ± 1.0） of experimental group,and was better than （4.3 ±2.1） of control group （P 〈0.05）.There was statistical difference in patient＇s satisfaction between the experimental group and control group （96.7% VS 83.3%,P 〈 0.05）.Conclusion The anatomical exposure of the entrance in throat of RLN can play an important role to accelerate the surgical process and reduce the incidence of complications for thyroid lobectomy.

关 键 词： 甲状腺腺叶切除术 喉返神经 解剖暴露