医学临床研究
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医学临床研究  2023, Vol. 40 Issue (6): 866-868    DOI: 10.3969/j.issn.1671-7171.2023.06.019
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喉返神经监测用于甲状腺癌根治术中的临床价值
刘云涵1, 王林林1, 孙宁宁1, 段铭杰2,*
1.山东省立第三医院手术室,山东 济南 250031;
2.山东第一医科大学第一附属医院麻醉科,山东 济南 250031
The Clinical Value of Recurrent Nerve Monitoring in Radical Thyroid Cancer Surgery
LIU Yun-han, WANG Lin-lin, SUN Ning-ning, et al
Shandong Provincial Third Hospital,Jinan Shandong 250031
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摘要 【目的】 探讨喉返神经监测用于甲状腺癌根治术中的临床价值。【方法】 选择2018年1月至2020年1月山东省立第三医院收治的112例甲状腺癌患者,采用随机数字表法将其分为观察组(术中采用神经监测仪)和对照组(术中未采用神经监测仪),每组56例。两组患者均行甲状腺单侧或双侧腺叶切除术联合淋巴结清扫术,观察组术中使用神经监测仪。记录两组手术相关指标,检测不同时点患者血钾浓度,记录两组患者术后喉返神经损伤情况、喉返神经辨识率和辨识时间以及并发症发生率。【结果】 观察组手术时间、引流管拔除时间、住院时间短于对照组,术中出血量、术后引流量低于对照组,差异有统计学意义(P<0.05)。术后0.5 h、1 h、3 h,两组患者血钾水平均高于术前,拔管后0.5 h显著低于术后3 h,观察组术后1 h、3 h和拔管后0.5 h血钾水平高于对照组,差异有统计学意义(P<0.05)。观察组喉返神经辨识时间低于对照组,喉返神经辨识率高于对照组,差异有统计学意义(P<0.05)。与对照组相比,观察组术后并发症总发生率为16.07%(9/56),低于对照组的46.43%(26/56),差异有统计学意义(χ2=12.01,P<0.05)。【结论】 喉返神经监测用于甲状腺癌根治术中可保护患者喉返神经,可有效提高手术安全性。
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刘云涵
王林林
孙宁宁
段铭杰
关键词 甲状腺肿瘤/外科学喉返神经甲状腺切除术    
Abstract:【Objective】 To explore the clinical value of Recurrent laryngeal nerve monitoring in radical thyroidectomy. 【Methods】 A total of 112 patients with thyroid cancer admitted to Shandong Provincial Third Hospital from January 2018 to January 2020 were selected and randomly divided into an observation group (with intraoperative use of a neural monitor) and a control group (without intraoperative use of a neural monitor) using a random number table method,with 56 patients in each group. Both groups of patients underwent unilateral or bilateral thyroidectomy combined with lymph node dissection,while the observation group used a neuromonitor during surgery. The operation related indexes of the two groups were recorded,the blood potassium concentration of patients at different time points was detected,and the Recurrent laryngeal nerve injury,Recurrent laryngeal nerve recognition rate,recognition time,and complication rate of the two groups were recorded. 【Results】 The observation group had shorter surgical time,drainage tube removal time,and hospital stay compared with the control group. The intraoperative bleeding volume and postoperative drainage volume were lower than those of the control group,and the difference was statistically significant (P<0.05). At 0.5 hours,1 hour,and 3 hours after surgery,the blood potassium levels of both groups of patients were higher than those before surgery,and at 0.5 hours after extubation,they were significantly lower than at 3 hours after surgery. The blood potassium levels of the observation group at 1 hour,3 hours after surgery,and 0.5 hours after extubation were higher than those of the control group,and the difference was statistically significant (P<0.05). The identification time of recurrent laryngeal nerve in the observation group was lower than that in the control group,and the identification rate of recurrent laryngeal nerve was higher than that in the control group,with a statistically significant difference (P<0.05). Compared with the control group,the total incidence of postoperative complications in the observation group was 16.07% (9/56),lower than 46.43% (26/56) in the control group,with a statistically significant difference(χ2=12.01,P<0.05). 【Conclusion】 Recurrent laryngeal nerve monitoring can protect Recurrent laryngeal nerve in patients with thyroid cancer during radical surgery,and can effectively improve the safety of surgery.
Key wordsThyroid Neoplasms/SU    Recurrent Laryngeal Nerve    Thyroidectomy
收稿日期: 2022-11-21     
中图分类号:  R736.1  
通讯作者: *E-mail:zp13153187820@163.com   
引用本文:   
刘云涵, 王林林, 孙宁宁, 段铭杰. 喉返神经监测用于甲状腺癌根治术中的临床价值[J]. 医学临床研究, 2023, 40(6): 866-868.
LIU Yun-han, WANG Lin-lin, SUN Ning-ning, et al. The Clinical Value of Recurrent Nerve Monitoring in Radical Thyroid Cancer Surgery. JOURNAL OF CLINICAL RESEARCH, 2023, 40(6): 866-868.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.06.019     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I6/866
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