甲状腺手术喉返神经损伤规律及治疗分析

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1、甲状腺手术喉返神经损伤规律及治疗分析怀化市第二人民医院头颈五官科湖南怀化418000【摘要】目的：分析甲状腺手术喉返神经损伤规律及治疗方法。方法：回顾性分析67例甲状腺手术喉返祌经损伤患者的临床资料，其中46例患者采取喉返祌经探查，其中22例患者出现缝线结扎或瘫痕粘连压迫喉返神经，并采取喉返神经减压术治疗；另外21例患者单纯采取保守治疗；分析喉返神经的缝线结扎、瘫痕粘连压迫损伤及喉返祌经切断损伤情况，并对比所有患者治疗前后的嗓音声学分析结果、喉神经电生理学检查结果。结果：46例甲状腺手术喉返神经损伤患者经喉返神经探查后，喉返神经被缝线结扎17例，占36.96%;瘫痕粘连压迫损伤5例，占10.

2、87%;喉返祌经切断损伤24例，占52.17%;损伤部位：近环甲关节处34例，占73.91%;甲状腺中下部12例，占26.09%;治疗后，手术治疗组的jitter、Shimmer,NNE均小于保守治疗组，经T检验，差异具有统计学意义(P<0.05)；治疗后，手术治疗组诱发电位大于保守治疗组，经T检验，差异具有统计学意义(P<0.05)。结论：喉返神经探查有利于了解甲状腺手术喉返神经损伤规律，采取喉返神经减压术治疗，对于恢复声带运动功能其有积极作用，值得临床推广使用。【关键词】甲状腺手术；喉返神经损伤；喉返神经减压术Thyroidsurgeryandthetreatmentofrecurren

3、tlaryngealnerveinjurylawYangZhipengHuaihuaCitySecondPeople’sHospitalENTHeadandNeckHunanHuaihua418000[Abstract]Objective：Toanalyzethelawofrecurrentlaryngealnerveinjuryinthyroidsurgeryandtreatment.Methods：Weretrospectivelyanalyzedtheclinicaldataof67casesofthyroidsurgeryinpatientswithrecurrentlaryngea

4、lnerveinjury，whichtake46patientsrecurrentlaryngealnerveexploration,whichappearsutureligationorscaradhesions22patientswithrecurrentlaryngealnerve,recurrentlaryngealnerveandtakedecompressiontreatment；anadditional21patientsweretreatedconservativelyalone；analysisoftherecurrentlaryngealnervesutureligati

5、on，scaradhesionscompressioninjuryanddenervationinjuryandcomparedbeforeandaftertreatment,allpatientsvoiceacousticanalysisresultslaryngealnerveelectrophysiologicalfindings.Results：46casesofthyroidsurgeryinpatientswithrecurrentlaryngealnerveinjuryafterrecurrentlaryngealnerveexploration，istherecurrentl

6、aryngealnervesutureligationin17cases，accountingfor36.96%；scaradhesionscompressioninjuryin5cases,accountingfor10.87%；24injurydenervationcases，accountingfor52.17%；injurysite：nearthecricothyroidjointsin34cases,accountingfor73.91%；thyroidinthelowerpartof12cases，accountingfor26.09%；aftertreatment，Jitter

7、surgerygroup，Shimmer，NNEwaslessthantheconservativetreatmentgroup，theTtest，thedifferencewasstatisticallysignificant(P<0.05);aftertreatment，surgicaltreatmentgroupevokedpotentialisgreaterthantheconservative