甲状腺微小癌的手术方式及减少喉返神经损伤的临床分析

• 作 者: 吴德虎
• 机 构: 盖州市中心医院，辽宁 营口 115200
• 出 处: 中国医药指南
• 发表日期: 2021年33期
• 关键词: Thyroid microcarcinoma Surgical method Recurrent laryngeal nerve injury

目的 本次研究旨在对甲状腺微小癌手术方式的选择以及减少喉返神经损伤的方法进行了探讨分析?方法以我院近年所接治的200例甲状腺微小癌患者作为研究对象，对两组对象诊治方式进行记录分析?结果 对200例研究对象均进行随访，随访时间不等，其中术后出现喉返神经损伤患者合计5例，其中4例出自未显露患者神经的手术患者;1例出自显露喉返神经的手术患者?5例喉返神经损伤患者皆为单侧损伤，经由对症处理后，声嘶情况均得以好转?喉返神经显露组以及喉返神经未显露组在喉返神经损伤发生率数据比较上并无显著差异(P>0.05)?5例患者“,”Objective The purpose of this study was to explore the selection of surgical methods for thyroid microcarcinoma and to reduce the injury of recurrent laryngeal nerve.Methods Two hundred cases of thyroid microcarcinoma treated in our hospital in recent years were taken as the study object，and the diagnosis and treatment of the two groups were recorded and analyzed.Results Two hundred cases subjects were followed up for different time，including 5 patients with recurrent laryngeal nerve (RLN) injury，4 patients without RLN exposure;1 patient underwent operation to expose recurrent laryngeal nerve.The recurrent laryngeal nerve injury was unilateral.After symptomatic treatment，the hoarseness was improved.There was no signi?cant difference in the incidence of recurrent laryngeal nerve injury between the exposed recurrent laryngeal nerve group and the non-exposed recurrent laryngeal nerve group (P>0.05).Local recurrence was found in 5 patients (2.50%).In 2 cases，the contralateral gland lobe recurred after subtotal resection of the affected gland lobe，isthmus and contralateral gland lobe，and in the remaining 3 cases local lymph node recurred.All 5 cases were resected and no recurrence was found.The other 195 patients were in good condition without metastasis，recurrence or death.Conclusion In the diagnosis of thyroid microcarcinoma，high-resolution color doppler ultrasound，?ne needle aspiration biopsy and intraoperative frozen pathological examination are reliable diagnostic methods.Surgery is the ideal way to treat the disease.Physicians need to choose surgical methods reasonably based on actual conditions to ensure long-term results.Exposing the recurrent laryngeal nerve during the operation and strengthening various protective measures are effective methods to reduce the damage of the recurrent laryngeal nerve.