CAJ | 학술논문

目的探讨甲状腺手术中解剖和识别Zuckerkandl结节(ZT)的意义.方法选择我院2009年1月至2011年6月进行的370例(501侧)甲状腺侧叶切除或全切除病例,在术中解剖和识别ZT,并观察其与喉返神经(RLN)及上甲状旁腺(SP)的关系.结果发现ZT为412侧(82.2％,412/501),其中ZT出现在甲状腺叶的后外侧中1/3者为368侧(89.3％,368/412).RLN走行在ZT后方者为379侧(92.0％,379/412).当ZT位于甲状腺叶的后外侧中1/3及下1/3时,SP均位于ZT的头侧偏前方,且80.1％的SP与ZT紧邻.RLN损伤发生率为0.40％(2/501),无SP损伤发生.结论在甲状腺手术中解剖和识别ZT,有助于识别和保护RLN及SP,从而减少手术并发症的发生,具有重要的临床意义.
목적 탐토갑상선수술중해부화식별Zuckerkandl결절(ZT)적의의.방법 선택아원2009년1월지2011년6월진행적370례(501측)갑상선측협절제혹전절제병례,재술중해부화식별ZT,병관찰기여후반신경(RLN)급상갑상방선(SP)적관계.결과 발현ZT위412측(82.2％,412/501),기중ZT출현재갑상선협적후외측중1/3자위368측(89.3％,368/412).RLN주행재ZT후방자위379측(92.0％,379/412).당ZT위우갑상선협적후외측중1/3급하1/3시,SP균위우ZT적두측편전방,차80.1％적SP여ZT긴린.RLN손상발생솔위0.40％(2/501),무SP손상발생.결론 재갑상선수술중해부화식별ZT,유조우식별화보호RLN급SP,종이감소수술병발증적발생,구유중요적림상의의.
Objective To Explore the significance of successful exposing and recognizing Zuckerkandl's tuhercle(ZT)during thyroidectomy.Methods Three hundred and seventy patients(501 sides) underwent lobectomy or total thyroidectomy from January 2009 to June 2011 were included in this study.The ZT was assessed in terms of its presence or absence,size and anatomical association with the recurrent laryngeal nerve(RLN)and superior parathyroid(SP).Results ZTs were found in 412 of 501 sides ( 82.2％ ),among which 368(89.3％ ) ZTs were located in the middle third of the lateral lobe of the thyroid gland.ZTs passed over the RLN in 379 of 412 sides(92.0％ ).When the ZTs were located in the middle or lower third of the lateral lobe of the thyroid gland,the SPs were all located in the cranial portion of ZT.The SP was adhered to the ZT in 80.1％ of the cases.RLN damage rate was 0.40％,and no SP damage occurred.Conclusion Exposing and recognizing Zuckerkandl's tubercle during thyroidectomy is of important clinical significance,which helps to identify and protect RLN and SP,so as to reduce surgical complications.