摘要
目的总结使用喉返神经监测系统在甲状腺开放手术全过程中,对喉返神经的监测、保护,以及使用体会与注意事项。方法①21例患者中甲状腺恶性肿瘤5例、良性肿瘤9例,甲状腺功能亢进症7例。②喉返神经监测系统主要由监测仪主机、喉返神经刺激探测针、专用接触声带的肌电图(electromyography,EMG)气管插管、接地传导回路电极针、抗干扰探头等组成。③手术采用三步法,首先显露颈迷走神经干检测仪器,再解剖、保护喉返神经,之后切除甲状腺组织。结果全部21例患者,术侧喉返神经均清晰显示,从甲状腺下级血管至入喉处。术后患者发音清晰,无饮水呛咳。结论甲状腺开放手术中,应用"喉返神经监测系统",可使喉返神经在手术全过程中得到切实保护,避免损伤发生。
OBJECTIVE To summarize the use of intraoperative neuromonitoring system for monitoring and protection of recurrent laryngeal nerve during thyroid surgery. METHODS There were 21 cases in this study, included 5 cases with thyroid cancer, 9 cases with thyroid benign tumor and 7cases with hyperthyroidism. Intraoperative neuromonitoring system includes the host monitor, stimulus detection pin of recurrent laryngeal nerve, special EMG endotracheal intubation tube which contacts vocal cord, grounding conductive circuit electrode, and anti-jamming probe. Operation method： a ＂three-step method＂ was adopted. First we revealed the cervical vagus nerve trunk and tested our instruments, and then dissected and protected the recurrent laryngeal nerve, followed by removal of thyroid tissue. RESULTS In all 21 patients, operative side recurrent laryngeal nerve were exposed from lower thyroid blood vessels to the larynx. All patients were phonated as well as before operation, and without drinking cough. CONCLUSION The intraoperative neuromonitoring system can avoid damage of the recurrent laryngeal nerves when we exposed the recurrent laryngeal nerve before resection of the thyroid tissue and tumor.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2010年第1期23-25,共3页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
甲状腺切除术
喉返神经
创伤和损伤
监测
手术中
Thyroidectomy
Recurrent Laryngeal Nerve
Wounds and Injuries
Monitoring
Intraoperative
