解剖尸體50具(100側(cè)喉返神經(jīng)),結(jié)果發(fā)現(xiàn):右側(cè)喉返神經(jīng)位于甲狀腺下動脈前方占50.0％，左側(cè)喉返神經(jīng)居下動脈后方為76.0％(P lt;0.05)；64側(cè)喉返神經(jīng)入喉前分為2～5支；89.0％喉返神經(jīng)經(jīng)甲狀腺懸韌帶內(nèi)側(cè)入喉，其入口位于甲狀軟骨下角前下方者占91.0％。在此基礎(chǔ)上，采取緊貼甲狀腺腺體縱行解剖甲狀腺懸韌帶的手術(shù)方法施行甲狀腺手術(shù)70例(83側(cè))，術(shù)中顯露喉返神經(jīng)39側(cè)，未顯露44側(cè)，均無喉返神經(jīng)損傷。作者認(rèn)為預(yù)防喉返神經(jīng)損傷的關(guān)鍵在于掌握其解剖特點(diǎn)，熟練手術(shù)技巧，而不在于是否常規(guī)顯露喉返神經(jīng)。
引用本文： 龔日祥,徐惠珍,朱精強(qiáng). 甲狀腺術(shù)中喉返神經(jīng)損傷的預(yù)防. 中國普外基礎(chǔ)與臨床雜志, 1996, 3(3): 149-151. doi: 復(fù)制
版權(quán)信息： ?四川大學(xué)華西醫(yī)院華西期刊社《中國普外基礎(chǔ)與臨床雜志》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編
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- 1. Roy AD, Gardiner RH, Niblock WM. Thyroidectomy and the recurrent laryngeal nerves .Lancet, 1956； 270 :988.
- 2. Hvidegaard T, Vase P, Jorgensen K, et al. Identification and functional recording of the recurrent nerve by electrical stimulation during neck surgery .Laryngoscope, 1983；93 :370.
- 3. Williams AF,F.R.C.S.Oldham,et al.Recurrent laryngeal nerve lesions during thyroidectomy.Surgery,1958;43:435.
- 4. Michael P,Kahky,Ranadals,et al.Complications of surgery of the thyroid and parathyroid glands .The Surg Clin Nor Am,1993;73(2):307.
- 5. Wade JSH, Cardiff MC. Vulnerability of the recurrent laryngeal nerves at thyroidectomy .Br J Surg, 1955；43 :164.