|
|
|
| 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 |
|
|
|
|
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.
|
|
Received: 21 November 2022
|
|
|
|
|
|
[1] 李兴睿,徐滔.美国癌症联合委员会第8版分化型甲状腺癌TNM分期更新解读[J].临床外科杂志,2019,27(1):33-35.
[2] 刘琪,王德伟. 精细化甲状腺被膜解剖技术联合环甲隙显露喉返神经方法在分化型甲状腺癌中的应用价值[J].中国普通外科杂志,2020,29(5):127-132.
[3] IWAKI S,MAEDA T,SAITO M,et al. Role of immediate recurrent laryngeal nerve reconstruction in surgery for thyroid cancers with fixed vocal cords[J].Head Neck,2017,39(3):427-431.
[4] 中华医学会内分泌学分会,中华医学会外科学分会内分泌学组,中国抗癌协会头颈肿瘤专业委员会,等. 甲状腺结节和分化型甲状腺癌诊治指南[J].中华核医学与分子影像杂志,2013,33(2):96-115.
[5] 任博博,闵琦.术前血小板淋巴细胞比值与甲状腺癌患者预后的相关性[J].医学临床研究,2021,38(8):1183-1186.
[6] 肖海.甲状腺癌手术导致喉返神经损伤的临床分析[J].河北医药,2019,41(4):595-597.
[7] 马自强,胡挺,陈立权. 喉返神经损伤在甲状腺癌根治术中的原因及防治体会[J].医学理论与实践,2014,27(2):145-147.
[8] 杨乐,黄建平,刘兆龙.甲状腺切除术中出现喉返神经受损的相关因素分析[J].中国临床医生杂志,2019,47(7):830-832.
[9] 马小鹏,赵沨,潘婉婉,等. 喉返神经“最下径路、隔热保护”在甲状腺癌手术中的应用[J].中华全科医学,2019,22(10):1637-1639.
[10] 杨乐,黄建平,刘兆龙.甲状腺切除术中出现喉返神经受损的相关因素分析[J].中国临床医生杂志,2019,47(7):830-832.
[11] 费阳,姚京,王世斌,等. 喉返神经监测技术在全腔镜cT1N0～1a分化型甲状腺癌根治术中的应用体会[J].腹腔镜外科杂志,2017,22(11):801-805.
[12] 李震生,陈若冰. 基于图谱的甲状腺癌根治术研究的现状、热点和趋势[J].中国普外基础与临床杂志,2019,26(6):706-710.
[13] 张晓健,张晓舟,姜楠楠,等.喉返神经监测技术在腔镜辅助cT1N0～1a分化型甲状腺癌手术中的应用研究[J].中国医学创新,2020,17(2):18-21. |
|
|
|
2023, Vol. 40 
