• 四川大學(xué)華西醫(yī)院普外二科(成都610041);

目的 通過對甲狀旁腺的解剖研究找出甲狀旁腺的形態(tài)學(xué)特點，并致力于甲狀旁腺損傷和喉返神經(jīng)損傷的預(yù)防。方法 對50例尸體的頸部進(jìn)行解剖，對甲狀腺周圍組織結(jié)構(gòu)和甲狀旁腺的數(shù)目、分布及與周圍結(jié)構(gòu)的關(guān)系進(jìn)行描述。結(jié)果 甲狀旁腺平均（3.52±0.48）個/例，主要集中在甲狀腺后內(nèi)側(cè)的“三區(qū)一帶”（即上甲狀旁腺主要集中在甲狀軟骨下角區(qū)域,下甲狀旁腺除異位甲狀旁腺外，主要分布于甲狀腺下極,甲狀腺下動脈是上、下甲狀旁腺分布的交替區(qū)； 由此3個區(qū)構(gòu)成了一個甲狀旁腺易損傷帶，即甲狀腺后內(nèi)側(cè)）。上甲狀旁腺多位于喉返神經(jīng)外側(cè)（67.8%），而下甲狀旁腺多位于喉返神經(jīng)內(nèi)側(cè)（71.9%），兩者的分布差異有統(tǒng)計學(xué)意義（P＜0.005）。甲狀腺后懸韌帶區(qū)域是上甲狀旁腺的主要分布區(qū)域，占85.0%； 胸腺舌葉內(nèi)異位甲狀旁腺多見（28.6%）。結(jié)論 通過對甲狀腺解剖結(jié)構(gòu)和特點的探討，我們認(rèn)為甲狀旁腺和喉返神經(jīng)的損傷在很大程度上是可以預(yù)防的，不應(yīng)該成為標(biāo)準(zhǔn)甲狀腺手術(shù)的羈絆。

引用本文： 李志輝,朱精強,魏濤,徐惠珍,吳曉英. 甲狀旁腺在人體中的分布特點及臨床意義(附50 例解剖研究報告). 中國普外基礎(chǔ)與臨床雜志, 2008, 15(5): 311-313. doi: 復(fù)制

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2. Nanka O, Libánsky P, Sedy J, et al. Surgical-anatomical study as a part of operative treatment of primary hyperparathyroidism [Ｊ]. Rozhl Chir, 2006; 85(12)∶618.
3. Sultana SZ, Mannan S, Sultana S, et al. Morphological study of parathyroid in relation to thyroid gland of bangladeshi people [Ｊ]. Mymensingh Med J, 2007; 16(2)∶137.
4. Jander HP, Diethelm AG, Russinovich NA. The parathyroid artery [Ｊ]. AJR Am J Roentgenol, 1980; 135(4)∶821.
5. Duh QY, Sancho JJ, Clark OH. Parathyroid localization. Clinical review [Ｊ]. Acta Chir Scand, 1987; 153(4)∶241.
6. Wingert DJ, Friesen SR, Iliopoulos JI, et al. Post-thyroidectomy hypocalcemia. Incidence and risk factors [Ｊ]. Am J Surg, 1986; 152(6)∶606.
7. Nobori M, Saiki S, Tanaka N, et al. Blood supply of the parathyroid gland from the superior thyroid artery [Ｊ]. Surgery, 1994; 115(4)∶417.
8. Johansson K, Ander S, Lennquist S, et al. Human parathyroid blood supply determined by laser-Doppler flowmetry [Ｊ]. World J Surg, 1994; 18(3)∶417.
9. Falk SA, Birken EA, Baran DT. Temporary postthyroidectomy hypocalcemia [Ｊ]. Arch Otolaryngol Head Neck Surg, 1988; 114(2)∶168.
10. Chaudhary IA, Afridi ZD, Samiullah, et al. To ligate or not the inferior thyroid artery to avoid hypocalcaemia after thyroid surgery [Ｊ]. J Ayub Med Coll Abbottabad, 2007; 19(2)∶19.
11. Araujo Filho VJ, Silva Filho GB , Brando LG, et al. The importance of the ligation of the inferior thyroid artery in parathyroid function after subtotal thyroidectomy [Ｊ]. Rev Hosp Clin Fac Med Sao Paulo, 2000; 55(4)∶113.
12. Dozois RR, Beahrs OH. Surgical Anatomy and Technique of Thyroid and Parathyroid Surgery [Ｊ]. Surg Clin North Am, 1977; 57(4)∶647.
13. Phitayakorn R, McHenry CR. Incidence and location of ectopic abnormal parathyroid glands [Ｊ]. Am J Surg, 2006; 191(3)∶418.
  1. 1. Bhattacharyya N, Fried MP. Assessment of the morbidity and complications of total thyroidectomy [Ｊ]. Arch Otolaryngol Head Neck Surg, 2002; 128(4)∶3892 Chow TL, Chu W, Lim BH, et al. Outcomes and complications of thyroid surgery: retrospective study [Ｊ]. Hong Kong Med J, 2001; 7(3)∶261.
  2. 2. Nanka O, Libánsky P, Sedy J, et al. Surgical-anatomical study as a part of operative treatment of primary hyperparathyroidism [Ｊ]. Rozhl Chir, 2006; 85(12)∶618.
  3. 3. Sultana SZ, Mannan S, Sultana S, et al. Morphological study of parathyroid in relation to thyroid gland of bangladeshi people [Ｊ]. Mymensingh Med J, 2007; 16(2)∶137.
  4. 4. Jander HP, Diethelm AG, Russinovich NA. The parathyroid artery [Ｊ]. AJR Am J Roentgenol, 1980; 135(4)∶821.
  5. 5. Duh QY, Sancho JJ, Clark OH. Parathyroid localization. Clinical review [Ｊ]. Acta Chir Scand, 1987; 153(4)∶241.
  6. 6. Wingert DJ, Friesen SR, Iliopoulos JI, et al. Post-thyroidectomy hypocalcemia. Incidence and risk factors [Ｊ]. Am J Surg, 1986; 152(6)∶606.
  7. 7. Nobori M, Saiki S, Tanaka N, et al. Blood supply of the parathyroid gland from the superior thyroid artery [Ｊ]. Surgery, 1994; 115(4)∶417.
  8. 8. Johansson K, Ander S, Lennquist S, et al. Human parathyroid blood supply determined by laser-Doppler flowmetry [Ｊ]. World J Surg, 1994; 18(3)∶417.
  9. 9. Falk SA, Birken EA, Baran DT. Temporary postthyroidectomy hypocalcemia [Ｊ]. Arch Otolaryngol Head Neck Surg, 1988; 114(2)∶168.
  10. 10. Chaudhary IA, Afridi ZD, Samiullah, et al. To ligate or not the inferior thyroid artery to avoid hypocalcaemia after thyroid surgery [Ｊ]. J Ayub Med Coll Abbottabad, 2007; 19(2)∶19.
  11. 11. Araujo Filho VJ, Silva Filho GB , Brando LG, et al. The importance of the ligation of the inferior thyroid artery in parathyroid function after subtotal thyroidectomy [Ｊ]. Rev Hosp Clin Fac Med Sao Paulo, 2000; 55(4)∶113.
  12. 12. Dozois RR, Beahrs OH. Surgical Anatomy and Technique of Thyroid and Parathyroid Surgery [Ｊ]. Surg Clin North Am, 1977; 57(4)∶647.
  13. 13. Phitayakorn R, McHenry CR. Incidence and location of ectopic abnormal parathyroid glands [Ｊ]. Am J Surg, 2006; 191(3)∶418.