| 马建仓,徐金锴,李宗禹,赖婧玥,关 昊,白育花.甲状腺术中喉返神经显露对暂时性喉返神经损伤发生率的影响[J].,2019,19(16):3102-3105 |
| 甲状腺术中喉返神经显露对暂时性喉返神经损伤发生率的影响 |
| Effect of Recurrent Laryngeal Nerve Exposure on the Incidence of Temporary Recurrent Laryngeal Nerve Injury during Thyroid Surgery |
| 投稿时间：2019-01-07 修订日期：2019-01-30 |
| DOI：10.13241/j.cnki.pmb.2019.16.019 |
| 中文关键词: 甲状腺切除术 喉返神经显露 暂时性喉返神经损伤 甲状旁腺激素 |
| 英文关键词: Thyroidectomy Recurrent laryngeal nerve Temporary recurrent laryngeal nerve injury Parathyroid hormone |
| 基金项目:陕西省科技攻关项目(2012SF2-13) |
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| 中文摘要: |
| 摘要 目的：探究甲状腺术中喉返神经显露对暂时性喉返神经损伤发生率的影响。方法：选择我院2016年10月-2018年10月收治的行甲状腺切除术的115例患者为研究对象，按照其入院顺序经随机数字表法分为两组，两组患者均行常规甲状腺切除术。其中，对照组58例患者未显露喉返神经；研究组57例患者常规显露喉返神经，记录并比较两组患者的手术时间、术中出血量、术后引流量、切口长度和住院时间等围术期手术指标，术后1d、4d、7d的甲状旁腺激素(PTH)水平、钙离子(Ca2＋)水平，术后暂时性喉返神经损伤、术后声音嘶哑、低钙血症等并发症的发生情况。结果：研究组患者的手术时间、术中出血量、术后引流量均短于(少于)对照组(P＜0.05)，但两组患者的切口长度和住院时间无显著性差异(P＞0.05)；研究组患者术后1d、4d、7d的血清PTH、Ca2＋水平均高于对照组(P＜0.05)，暂时性喉返神经损伤、术后声音嘶哑、低钙血症发生率均低于对照组(P＜0.05)。结论：甲状腺术中喉返神经显露可有效预防暂时性喉返神经和甲状腺功能的损伤，降低术后并发症的发生率，且患者的围术期指标均显著改善。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of recurrent laryngeal nerve exposure on the incidence of temporary recurrent laryngeal nerve injury during thyroid surgery. Methods: A total of 115 patients who underwent thyroidectomy from October 2016 to October 2018 in our hospital were enrolled in the study. They were divided into two groups according to their admission order by random number table method. Both groups underwent routine thyroidectomy. Among them, 58 patients in the control group did not show recurrent laryngeal nerve; 57 patients in the study group routinely showed recurrent laryngeal nerve. The perioperative surgical indexes such as operation time, intraoperative blood loss, postoperative drainage volume, incision length and hospitalization time were recorded and compared between the two groups. The levels of serum parathyroid hormone (PTH) and calcium (Ca2+) at 1d, 4d and 7d after operation, the complications of postoperative temporary recurrent laryngeal nerve injury, postoperative hoarseness and hypocalcemia were compared between two groups. Results: The operation time, intraoperative blood loss and postoperative drainage volume of study group were significantly shorter than (less than) those of the control group (P<0.05). However, there was no significant difference in the incision length and hospitalization time between the two groups (P>0.05). The serum PTH and Ca2+ levels of study group were significantly higher than those of the control group at 1d, 4d and 7d after operation (P<0.05). The incidence of temporary recurrent laryngeal nerve injury, postoperative hoarseness and hypocalcemia in the study group were significantly lower than those in the control group (P<0.05). Conclusion: Throat retinal nerve exposure during thyroid surgery can effectively prevent temporary recurrent laryngeal nerve and thyroid function damage, reduce the incidence of postoperative complications, and the perioperative period of the patients are significantly improved. |
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