甲状腺手术中甲状旁腺和喉神经功能损伤的防治策略

发布时间：2018-02-02 19:15

本文关键词： 甲状腺手术医源性损伤甲状旁腺喉神经预防和处理　出处：《中国肿瘤临床》2017年09期 　论文类型：期刊论文

【摘要】：外科手术是治疗甲状腺恶性肿瘤和部分良性肿瘤主要方法,其中分化型甲状腺癌(differentiated thyroid carcinoma,DTC)手术占绝大部分。尽管外科手术技术在不断发展和进步,但因甲状腺手术导致的甲状旁腺和神经功能损伤仍然不能完全避免。本文从甲状腺手术的方式和范围、局部解剖学变异和二次甲状腺手术的角度系统分析了导致甲状旁腺和喉神经(包括喉上神经和喉返神经)损伤的原因,从如何正确把握甲状腺肿瘤手术治疗的原则、适应证和手术中的精细化操作及围手术期的处理等方面详细论述了甲状腺手术中甲状旁腺和喉神经功能保护和恢复的原则与策略。本文旨在对临床上有效预防和妥善处理甲状腺手术的主要并发症提供参考。
[Abstract]:Surgery is the main method for the treatment of thyroid neoplasms and some benign tumors, among which differentiated thyroid carcinoma are differentiated thyroid carcinomas. DTC (DTC) surgery accounts for the majority, although surgical techniques continue to evolve and improve. But the parathyroid gland and nerve function damage caused by thyroid surgery can not be completely avoided. The causes of parathyroid gland and laryngeal nerve injury (including superior laryngeal nerve and recurrent laryngeal nerve) were systematically analyzed by local anatomical variation and the angle of secondary thyroid surgery. From how to correctly grasp the principle of surgical treatment of thyroid tumor. The principles and strategies for the protection and recovery of parathyroid gland and laryngeal nerve function in thyroid surgery are discussed in detail in terms of indications, fine operation during operation and perioperative management. The purpose of this article is to effectively prevent and restore parathyroid gland and laryngeal nerve function in thyroid surgery. Proper management of major complications of thyroid surgery provides a reference.
【作者单位】：解放军白求恩国际和平医院耳鼻咽喉头颈外科;解放军白求恩国际和平医院耳鼻咽喉头颈外;
【分类号】：R653
【正文快照】： 近年来,甲状腺结节的发病率呈逐年升高的趋势。有研究发现,甲状腺结节通过触诊和高分辨率B超获得的人群患病率分别为3%~7%和20%~76%,其中约7%~15%的结节为甲状腺癌[1]。最新研究证明,甲状腺癌发病率在我国呈明显升高趋势,其病理类型以分化型甲状腺癌(differentiated thyroid c

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