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目的:为颈胸段前路手术中对喉返神经的定位和保护提供解剖学基础。方法:解剖40具成人颈胸部尸体标本,在颈胸段前路手术区对喉返神经进行解剖、观察和测量。结果:(1)左、右喉返神经颈内脏筋膜穿入点范围分别水平对应T2/3椎间盘、T3椎体(占85.0%)和C7/T1椎间盘、T1椎体(占87.2%);(2)颈部左、右侧喉返神经分别为94.5%、59.6%走行在气管食管沟内;左、右喉返神经在迷走神经的返折点范围分别水平对应T3/4椎间盘、T4椎体(占75.0%)和T1/2椎间盘、T2椎体(占82.5%);(3)非返性喉返神经1例,喉返神经的分支与颈交感干有交通2例,均出现在右侧;(4)左喉返神经10.0%在甲状腺下动脉之前,57.5%在其之后,32.5%在其分支之间;右喉返神经35.0%在动脉之前,22.5%在其之后,42.5%在其分支之间。结论:在颈胸段前路手术中,左、右侧入路分别在T2/3和C7/T1椎间盘水平以上操作是较安全的,但以采取左侧入路为宜,应注意喉返神经的变异。
Objective: To provide an anatomical basis for the location and protection of recurrent laryngeal nerve in anterior cervical approach. Methods: 40 adult cervical and thoracic carcass specimens were dissected, and the recurrent laryngeal nerve was anatomized, observed and measured in the anterior thoracic surgery area. Results: (1) The entrance of cervical visceral fascia to the left and right recurrent laryngeal nerves corresponded to T2 / 3 intervertebral disc, T3 vertebral body (85.0%) and C7 / T1 intervertebral disc, and T1 vertebral body (87.2% (2) The left and right recurrent laryngeal nerves of the neck were 94.5% and 59.6% respectively. The left and right recurrent laryngeal nerves returned to the T3 / 4 intervertebral disc and the T4 vertebral body (75.0%) and T1 / 2 intervertebral disc and T2 vertebra (82.5%). (3) Non-recurrent laryngeal recurrent nerve in 1 case, branch of recurrent laryngeal nerve and cervical sympathetic trunk had traffic in 2 cases, (4) the left recurrent laryngeal nerve 10.0% before the thyroid artery 57.5% after it, 32.5% between its branches; the right recurrent laryngeal nerve 35.0% before the artery 22.5% after it 42.5% Between its branches. Conclusion: In the anterior approach to the neck and thoracic surgery, it is safer to operate the left and right sides above the T2 / 3 and C7 / T1 discs respectively. However, it is advisable to take the left approach, and the recurrent laryngeal nerve Variation.