CAJ | 학술논문

目的探讨甲状腺手术中常规显露喉返神经(RLN)对保护神经的作用.方法回顾性分析2009年至2010年间连续实施的232例甲状腺切除手术患者的资料.手术均由同一组医师实施,方式为甲状腺腺叶切除或全切除术,术中常规显露喉返神经.结果共行腺叶切除181例,甲状腺全切除51例.术中解剖喉返神经280根(98.9%).术后10例患者(3.6%)出现声音嘶哑,其中7例术中证实了喉返神经的完整性,但声带检查出现患侧运动障碍,均在术后2个月内发音恢复正常.另外3例为术中离断性神经损伤并行即刻吻合者,在术后4个月内声音均恢复正常.结论甲状腺手术中常规显露喉返神经是预防喉返神经永久性损伤的有效方法.
목적 탐토갑상선수술중상규현로후반신경(RLN)대보호신경적작용.방법 회고성분석2009년지2010년간련속실시적232례갑상선절제수술환자적자료.수술균유동일조의사실시,방식위갑상선선협절제혹전절제술,술중상규현로후반신경.결과 공행선협절제181례,갑상선전절제51례.술중해부후반신경280근(98.9%).술후10례환자(3.6%)출현성음시아,기중7례술중증실료후반신경적완정성,단성대검사출현환측운동장애,균재술후2개월내발음회복정상.령외3례위술중리단성신경손상병행즉각문합자,재술후4개월내성음균회복정상.결론 갑상선수술중상규현로후반신경시예방후반신경영구성손상적유효방법.
Objective To investigate the significance of routine exposure of recurrent laryngeal nerve (RLN)in thyroidectomy.Methods The data of consecutive 232 patients with thyroidectomies during 2009-2010 were retrospectively reviewed.All operations,either lobectomy or total thyroidectomy were performed by the same surgeons.The RLN was identified routinely during the operation.Results Totally 280 RLNs were exposed in 181 thyroid lobectomies and 51 total thyroidectomies(98.9%).Ten patients experienced post-operative hoarseness(3.6%).Seven patients were diagnosed with paralysed vocal cord post-operatively,although the RLN were identified intact during the surgeries,and their voice became normal in 2 months.Another 3 patients'RLNs were transected injured and re-anastomosed during the same procedures and their voice became normal in 4 months.Conclusions Exposing the recurrent laryngeal nerve in the thyroidectomy is an effective way to prevent permanent injury to RLN.