摘要
目的探讨精细膜解剖技术在甲状腺手术中保护喉返神经与甲状旁腺中的作用。方法回顾性分析我院2010年1月至2017年12月行甲状腺手术病人211例临床资料。结果211例病人均顺利完成手术,无手术死亡病例。平均手术时间85 min,术后病理诊断,其中乳头状癌48例,髓样癌1例,甲状腺腺瘤21例,结节性甲状腺腺肿141例。术后有12例(4. 8%)发生短暂性有症状低钙血症,经对症治疗1周至1个月后症状消失;有3例(1. 4%)术后出现声音嘶哑,观察一个月后均恢复正常,未发生永久性低钙血症,未发生永久性喉返神经损伤,随访期间,均未见肿瘤复发。结论精细膜解剖技术能有效保护甲状旁腺及喉返神经,能降低甚至避免甲状旁腺及喉返神经的损伤,是临床上值得推广的一种手术理念。
Objective To explore the clinical significant on protection of parathyroid and recurrent laryngeal nerve(RLN)by meticulous capsular dissection in thyroid lobectomy.Methods Clinical date of 211 patients who underwent thyroid lobectomy by meticulous capsular dissection were retrospectively analyzed. Results All of the 211cases underwent thyroid lobectomy successfully without death,and the operative time was 85 min.The pathological results showed that there were thyroid papillary carcinoma in 48 cases,thyroid medullary carcinoma in one case,thyroid adenoma in 21 cases and nodular goiter in 141cases.After operation,12 cases suffered transient hypocalcemia whose symptom disappeared witnin one week to one month after therapy;3 cases suffered hoarseness whose symptom disappeared after one month,there was no case suffering permanent hypocalcemia and laryngeal nerve injury.There was no recurrence happened during the followed up period.No recurrence was found during the follow up period. Conclusion Meticulous capsular dissection can effectively protect function of parathyroid and reduce or stop the injury of RLN,so meticulous capsular dissection is worth using in the clinical practice.
作者
刘胜新
吴兰艳
徐军辉
李震
LIU Shengxin;WU Lanyan;XU Junhui(Department of General Surgery,the Third Renmin Hospital of Hubei Province,Wuhan 430033,China)
出处
《临床外科杂志》
2018年第11期839-841,共3页
Journal of Clinical Surgery
关键词
精细膜解剖技术
甲状腺手术
喉返神经
甲状旁腺
应用
meticulous capsular dissection
thyroid surgery
laryngeal recurrent nerve
parathyroid gland
application
作者简介
通信作者:李震,Email:lizhen10220@znhospital.cn
