中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (08): 680-683.

• 论著 • 上一篇    下一篇

非返性喉返神经的术前判定及术中处理

张    平，张    浩，李    璇，丁    奎，罗英伟，马文峰，辛世杰   

  1. 中国医科大学附属第一医院普通外科教研室血管甲状腺外科，辽宁沈阳 110001
  • 出版日期:2010-08-01 发布日期:2010-08-02

  • Online:2010-08-01 Published:2010-08-02

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摘要：

目的    总结甲状腺手术术前判定和术中识别非返性喉返神经经验。方法    回顾性分析中国医科大学附属第一医院血管甲状腺外科2008年8月至2010年2月甲状腺病人存在非返性喉返神经4例病人的临床资料，探讨非返性喉返神经的术前判定和术中识别及保护技巧。结果    4例均为右侧ⅡA型非返性喉返神经，术前颈部增强CT提供诊断依据，手术均无损伤。结论    术前颈部增强CT发现食管后方异常右锁骨下动脉，高度提示右侧非返性喉返神经存在，术中仔细操作，有助于避免损伤。

关键词: 非返性喉返神经, 右锁骨下动脉, 甲状腺切除术

Abstract:

Preoperative prediction and intraoperative treatment of nonrecurrent laryngeal nerve        ZHANG Ping, ZHANG Hao，LI Xuan,et al. Department of General Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
Corresponding author: ZHANG Hao，E-mail: haozhang@mail.cmu.edu.cn
Abstract    Objective    To evaluate preoperative judgment and intraoperative identification of nonrecurrent laryngeal nerve (NRLN) during thyroidectomy. Methods    The clinical data of 4 cases of thyroid surgery associated with a right NRLN from August 2008 to February 2010 in the Department of Vascular and thyroid, the First Hospital of China Medical University were analyzed retrospectively. Results    The preoperative CT scan showed a retroesophageal aberrant right subclavian artery in all 4 cases. They had identification of TypeⅡA NRLN on the right side. Postoperatively, the patient had normal vocal cord function on laryngoscopy. Conclusions    It is possible to predict preoperatively a right NRLN by identifying an aberrant right subclavian artery on the CT film of the neck, which likely enabled the prevention of vocal cord paralysis.

Key words: nonrecurrent laryngeal nerve, right subclavian artery, thyroidectomy