肿瘤预防与治疗2019，Vol.32Issue(12)：1113-1118,6.DOI:10. 3969／j. issn. 1674-0904. 2019. 12. 009
Zuckerkandl结节在甲状腺手术中对上甲状旁腺的定位及喉返神经的保护作用研究*
Effects of Zuckerkandl Tubercle on Superior Parathyroid Localization and Recurrent Laryngeal Nerve Protection in Thyroid Surgery
摘要
Abstract
Objective: To analyze the clinical significance of Zuckerkandl’s tubercle (ZT) and its anatomical relation-ship with superior parathyroid ( SP) and recurrent laryngeal nerve ( RLN ) in thyroid surgery. Methods: Data of 324 patients who underwent continuous total thyroidectomy or near-total thyroidectomy in the same group in our hospital from Feb-ruary 2017 to March 2019 were analyzed retrospectively. Dis- tribution and size of ZT, and its anatomical relationship with RLN and SP were observed. Effects of ZT on SP localization and RLN protection were analyzed. Results: Intraoperative anatomy showed that there were 267 cases (82. 41% ) with left ZT, 288 cases (88. 89% ) with right ZT, and 246 cases (75. 93% ) with bilateral ZT. Both left and right ZT were in grade II (49. 44% , 51. 04% ). The difference was not significant (Uc=0. 172, P=0. 863). There were 15 cases (7. 81% ) with left SP located at 3 o’clock of ZT, 153 cases (79. 69% ) at 2 o’clock, and 24 cases (12. 50% ) at 1 o’clock. There were 21 cases (10. 00% ) with right SP located at 11 o’clock of ZT, 180 cases (85. 71% ) at 10 o’clock and 9 cases (4. 29% ) at 9 o’clock. The left and right ZT was mainly distributed at 2 and 10 o’clock. ZT and anatomical type of RLN in the left side was not significantly different from those in the right side (Uc=1. 012, P=0. 314). RLN was more likely to pass through the rear of ZT when ZT grade was higher. There were no significant differences among different ZT grades in the inci-dence of transient trachyphonia and hypocalcemia (Uc=0. 324, 0. 035; P=0. 128, 0. 497). Conclusion: ZT can be ap-plied as an effective marker for locating and identifying RLN and SP in thyroid surgery. It is of great significance in guiding RLN localization and SP protection in thyroid surgery.关键词
甲状腺手术/Zuckerkandl结节/上甲状旁腺/喉返神经/解剖关系Key words
Thyroid surgery/Zuckerkandl tubercle/Superior parathyroid/Recurrent laryngeal nerve/Anatomical rela-tionship分类
医药卫生引用本文复制引用
郑跃彬,鄢斌成,蔡永聪,杨羿容..Zuckerkandl结节在甲状腺手术中对上甲状旁腺的定位及喉返神经的保护作用研究*[J].肿瘤预防与治疗,2019,32(12):1113-1118,6.基金项目
四川省科技厅重点研发项目(编号:2019 YFS0337) This study was supported by grants from Science and Technology Department of Sichuan Province (2019YFS0337). （编号:2019 YFS0337）
