摘要
目的探讨喉返神经监测在甲状腺癌二次手术淋巴结清扫术中的应用效果。方法将本科室2017年1月至2018年4月收治的60例甲状腺癌二次手术淋巴结清扫术患者纳入本研究,按随机数表法将患者分为未监测组(n=30,常规手术)和监测组(n=30,喉返神经监测辅助手术),比较两组术中喉返神经识别成功率、术中出血量、手术时间、淋巴结清扫数、术后引流量、并发症及声带恢复情况。结果监测组术中喉返神经识别成功率明显高于未监测组(P<0.05)。监测组的手术时间明显短于未监测组(P<0.05);监测组术后1、2、3 d引流量及总引流量均明显少于未监测组(P<0.05);监测组喉返神经损伤发生率明显低于未监测组(P<0.05);监测组术后1 d、术后1周声带运动异常发生率明显低于未监测组(P<0.05)。结论在甲状腺癌二次手术淋巴结清扫术中应用喉返神经监测可减轻喉返神经损伤,缩短手术时间,减少术后引流量,且对淋巴结清扫效果无明显影响。
Objective To investigate the application effect of recurrent laryngeal nerve monitoring on secondary surgical lymph node dissection in thyroid cancer.Methods Sixty patients with thyroid cancer underwent secondary surgical lymph node dissection in our department from January 2017 to April 2018 were enrolled in the study.The patients were divided into non-monitoring group(n=30,routine surgery)and monitoring group(n=30,recurrent laryngeal nerve monitoring assisted surgery)according to the random number table method.The success rates of recurrent laryngeal nerve recognition,intraoperative bleeding volume,operative time,numbers of lymph node dissection,postoperative drainage,complications and vocal cord recovery of the two groups were cpmpared.Results The success rate of recurrent laryngeal nerve recognition in the monitoring group was significantly higher than that in the non-monitoring group(P<0.05).The operation time of the monitoring group was significantly shorter than that of the non-monitoring group(P<0.05).The drainage volume at the 1,2,3 d after operation and total drainage volume of the monitoring group were significantly less than those of the non-monitoring group(P<0.05).The incidence of recurrent laryngeal nerve injury in the monitoring group was significantly lower than that in the non-monitoring group(P<0.05).The incidences of abnormal vocal cord movement in the monitoring group at 1 d and 1 week after operation were significantly lower than those in the non-monitoring group(P<0.05).Conclusion The use of recurrent laryngeal nerve monitoring in the secondary surgical lymph node dissection of thyroid cancer can reduce the recurrent laryngeal nerve injury,shorten the operation time,reduce the postoperative drainage and has no significant effect on lymph node dissection.
作者
王东
冯蓉
WANG Dong;FENG Rong(E.N.T.Department,Yan'an People's Hospital,Yan'an 716000,China)
出处
《临床医学研究与实践》
2019年第5期53-55,共3页
Clinical Research and Practice
关键词
甲状腺癌
二次手术
淋巴结清扫术
喉返神经
thyroid cancer
secondary surgery
lymph node dissection
recurrent laryngeal nerve
