摘要
目的:观察分阶段康复治疗对甲状腺术后暂时性喉返神经损伤恢复的临床疗效。方法:共选取32例甲状腺术后暂时性喉返神经损伤患者,将其随机分为治疗组及对照组。治疗组给予分阶段规范化康复治疗:第一康复阶段指术后至术后2周,行超短波治疗;第二康复阶段指术后2周至2个月,行红外线偏振光照射结合中频电治疗;第三康复阶段指术后2个月至3个月,行直流电离子导入结合中频电治疗。另外,在二、三阶段以及以后的康复中,结合发音训练治疗。对照组未给予物理康复治疗。以电子喉镜检查声带运动与声门闭合。结果:治疗组患者病程3个月内电子喉镜检查,声带运动恢复正常、声门闭合完全者达到11例(68.75%),高于对照组5例(32.25%),P<0.05;随访至4个月,治疗组患者恢复达100%,对照组仅有11例(68.75%),P<0.05;6个月时对照组患者完全恢复。2组的散点回归方程,治疗组斜率(4.0)大于对照组斜率(2.9),治疗组恢复快于对照组。主观嗓音评估中简化嗓音障碍指数(VHI-10)在第3、4、5个月,治疗组均明显好于对照组(P<0.05)。结论:规范化分阶段康复治疗对甲状腺术后暂时性喉返神经损伤患者的声音恢复具有显著疗效。
Objective： To observe the effect of phased rehabilitative treatment in temporary recurrent laryngeal nerve （RLN） injury after thyroidectomy. Method： A total of 32 temporary RLN injury patients after thyroidectomy were randomly divided into treat- ment group and control group. The patients in treatment group were given phased rehabilitative treatment. The first rehabilitation stage was referred to the term from defining RLN injury to two weeks later and the pa- tients would be treated with ultrashort wave therapy. The second rehabilitation stage was meant the term from 2 weeks to 2 months after operation and the patients would be cured with polarized infrared irradiation com- bined with medium frequency（electrotherapy）. The third rehabilitation stage was the duration from 2 months to 3 months after operation and patients would treated with iontophoresis combined with medium frequenoy-electro- therapy. In addition, the pronunciation training was added in the second and third stages as well as the subse- quent rehabilitation. The movement of the vocal cords and glottal closure of the patients were checked by elec- tronic laryngoscopy. Result： After treated for 3 months, there were 11 patients of treatment group and 5 patients of control group whose movement of vocal cords returned to normal and glottal closed completely. The difference between two groups was significant（P〈0.05）. At the end of fourth month, all the patients of treatment group and 11 pa- tients of control group recovered completely（P〈0.05）. The patients of control group recovered fully until 6months later. Voice handicap index-10（VHI-10） of treatment group was better than control group from the third month to the fifth month（P〈0.05）. Conclusion： The standardized phased rehabilitation has postoperative temporary recurrent laryngeal nerve injury remarkable curative effect for patients suffering from after thyroidectomy and of great significance to pro- mote patient early return to society. Author＇s address The Huabei Oil Field General Hospital of Hebei Medical University,062552
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2013年第9期826-829,共4页
Chinese Journal of Rehabilitation Medicine
关键词
分阶段康复治疗
喉返神经损伤
甲状腺手术
phased rehabilitative treatment
recurrent laryngeal nerve iniury
thyroidectomv
