一位病人剛接受甲狀腺切除術，護理師發現病人出現聲音嘶啞且說話困難。請問護理師最優先的擔憂為何？
A nurse is caring for a client following a thyroidectomy. The nurse notes the client has developed hoarseness and difficulty speaking. What is the nurse's priority concern?
- ARisk of postoperative hemorrhage術後出血的風險
- BDevelopment of a thyroid storm發展成甲狀腺風暴
- CPostoperative pain management術後疼痛管理
- DDamage to the laryngeal nerve✓ 正解喉返神經損傷
甲狀腺切除術後若出現聲音嘶啞或說話困難，應高度懷疑喉返神經受損（Laryngeal nerve damage）。這不僅影響發聲，若雙側受損更可能導致嚴重的呼吸道阻塞，屬於術後重大併發症。術後護理應密切監測呼吸道狀況，必要時準備氣切設備。
If a client develops hoarseness or difficulty speaking after a thyroidectomy, recurrent laryngeal nerve injury should be strongly suspected. Not only does this affect phonation, but if both nerves are damaged it may also lead to severe airway obstruction, which is a major postoperative complication. Postoperative care must include close monitoring of airway status, with tracheostomy equipment readily available if needed.
台美皆將神經損傷列為術後重大監測項目，台灣外科醫師對於此併發症的預防措施相當嚴謹。