Chaudhary Ishtiaq Ahmed, Masood Rehan, Majrooh Muhammad Ashraf, Mallhi Ashraf Ali
Department of Surgery, Foundation University Medical College, Rawalpindi.
J Ayub Med Coll Abbottabad. 2007 Jul-Sep;19(3):46-50.
Thyroid surgery has been associated with complications ranging from nerve injury to death. Improvements in techniques have reduced the mortality rate to minimum. Morbidity, however, remains a significant concern. This study was designed to determine the prevalence of recurrent laryngeal nerve (RLN) injury and duration of recovery following transient recurrent laryngeal nerve injury, during thyroid surgery.
This prospective, observational study was carried out in the Surgical Department of Fauji Foundation Hospital, Rawalpindi, from January 2000 to December 2005. All patients undergoing Thyroid surgery were included.
310 patients, predominantly female (97.09%), were operated. Majority were euthyroid (90.33%). 3.22% patients had recurrent laryngeal nerve injury. Amongst them, 87.5% had transient and 12.5% had permanent nerve lesion. Majority of the patients (87.5%) showed signs of recovery within 12 weeks after surgery. Injury was observed more in huge goiters (3.57% transient and 1.42% permanent), total thyroidectomy (7.69% transient and 3.84% permanent) and during lobectomy and total thyroidectomy (6.25% respectively for transient and permanent nerve injury.
Thyroid surgery should be done by experienced surgeon and care should be taken especially in huge goiters and patients undergoing total thyroidectomy.
甲状腺手术可能引发从神经损伤到死亡等一系列并发症。技术的改进已将死亡率降至最低。然而，发病率仍是一个重大问题。本研究旨在确定甲状腺手术期间喉返神经（RLN）损伤的发生率以及短暂性喉返神经损伤后的恢复时间。
这项前瞻性观察性研究于2000年1月至2005年12月在拉瓦尔品第的福吉基金会医院外科进行。纳入所有接受甲状腺手术的患者。
共对310例患者进行了手术，其中女性占主导（97.09%）。大多数患者甲状腺功能正常（90.33%）。3.22%的患者发生了喉返神经损伤。其中，87.5%为短暂性损伤，12.5%为永久性损伤。大多数患者（87.5%）在术后12周内出现恢复迹象。巨大甲状腺肿患者的损伤更为常见（短暂性损伤3.57%，永久性损伤1.42%），全甲状腺切除术患者（短暂性损伤7.69%，永久性损伤3.84%），以及在甲状腺叶切除术和全甲状腺切除术中（短暂性和永久性神经损伤分别为6.25%）。
甲状腺手术应由经验丰富的外科医生进行，尤其在处理巨大甲状腺肿和接受全甲状腺切除术的患者时应格外小心。
