摘要
甲状旁腺腺瘤或增生的摘除术和甲状腺次全切除术等,均要熟悉甲状旁腺的位置。在100例颈部标本中共发现319个甲状旁腺,平均每例3.19个。80%的甲状旁腺位于正常的较为隐蔽的位置,即上一对位于甲状腺侧叶后缘中点以上到上1/4与下3/4交界处;下一对位于甲状腺侧叶后缘的下1/3段。它们都在甲状腺固有囊与筋膜鞘之间。甲状腺次全切除一般是保留侧叶后部,这是保护甲状旁腺、防止损伤喉返神经的有效措施,更重要的是要严格紧靠甲状腺固有囊清理并完整保留固有囊外、侧叶上下端附近的脂肪组织和疏松结缔组织,这对占16%的变异位置的甲状旁腺免遭切除更有保证。即使是甲状腺侧叶全部切除,同此处理,也可保存甲状旁腺。甲状旁腺腺瘤或增生的摘除术要广泛探查,但应首先在甲状腺侧叶下端附近及其下方的气管两旁探查下一对甲状旁腺的情况,因为下一对甲状旁腺有的恰好是位于甲状腺侧叶下端;位于侧叶下端下方气管两旁者占4%。
The knowledge of the location of the parathyroid glands is valuable in the parathyroidectomy and subtotal thyroidectomy.319 parathyroid glands have been found in 100 cases.80%of the parathyroid glands are situated in tile normal yet concealed position:the upper pair,above the mid of the posterior margin of the lateral lobe of the thyroid gland,while the lower pair,near the inferior 1/3 of the posterior margin of the lateral lobe.They all lie in the space between the proper capsula and fascia sheath of the thyroid gland.In subtotal thyroidectomy,the posterior part of the lateral lobe is usually preserved,it aims to protect the parathyroid gland,and is an effective procedure to prevent the injury of the recurrent nerve.Morever,it is most important to preserve the fat and loose connective tissue near the lateral lobe of the proper capsule,in order to avoid the excission of the parathyroid glands on abnormal locations(16%).In procedure of the operation on parathyroidoma or hyperparathyroidism,the first thing is to examine the condition of the lower pair parathyroid glands,which usually lie near or below the lower end of the lateral lobe and on the both sides of trachea.If the lower pair of parathyroid glands is identified to be pathological in nature,then the examination of the other pair can be performed on routine.4%of the lower pair of the parathyroid glands are found on the both sides of trachea.A clear standard statistical diagram of the location of the parathyroid gland has been designed in this study.
作者
邱治民
邹宁生
Qiu Zhimin;Zou Ningsheng(Department of Anatomy,Fujian Medical University)
出处
《解剖学报》
CAS
1981年第1期28-32,共5页
Acta Anatomica Sinica
