摘要
目的探讨经颈超声检查评估咽喉部手术患者声带运动异常的应用价值。方法选取2021年1月至2023年12月在海南省人民医院行甲状腺或咽喉部手术的49例患者纳入研究,所有患者术前及甲状腺患者术后均行喉镜及颈部超声检查声带运动情况,以喉镜评估声带运动为金标准,比较经颈超声与喉镜检查在评估声带运动方面有无差异。结果49例患者中行甲状腺肿瘤手术34例,术前超声检查显示声带区28例,超声与喉镜检查声带运动均正常。术后喉镜及超声检查均发现2例患者一侧声带固定,另喉镜提示1例患者一侧声带运动减弱,超声检查无阳性发现。喉部手术患者15例,均为喉癌;超声显示声带区结构的12例患者术前喉镜提示9例一侧声带固定,超声均正确诊断;另超声提示2例气道狭窄,声带运动减弱,因气道狭窄喉镜检查无法窥探至声带平面。将40例超声及喉镜均可显示声带区患者的声带运动情况进行比较,两者具有高度的一致性(Kappa值=0.826,P<0.001)。结论经颈超声检查作为一种非侵入式检查手段对部分患者声带运动情况的评估结果与喉镜检查结果具有高度的一致性,且简便易行,患者无需特殊准备,检查过程无痛苦,具有临床应用价值。
Objective To explore the application value of transcervical ultrasound in evaluating abnormal vocal cord movement in patients undergoing laryngopharyngeal surgery.Methods A total of 49 patients undergoing thyroid or laryngopharyngeal surgery in Hainan General Hospital from January 2021 to December 2023 were selected for the study.All patients underwent laryngoscopy and cervical ultrasound to check the vocal cord movement before and after thyroid surgery.Taking laryngoscopy as the gold standard,the differences in evaluating vocal cord movement between transcervical ultrasound and laryngoscopy were compared.Results Among the 49 patients,34 underwent thyroid tumor surgery,and 28 of them showed vocal cord area in preoperative ultrasound examination.Both ultrasound and laryngoscopy showed normal vocal cord movement.Postoperative laryngoscopy and ultrasound examination found that 2 patients had fixed vocal cords on one side.In addition,laryngoscopy suggested that 1 patient had weakened vocal cord movement on one side,and ultrasound examination showed no positive findings.Among the 15 patients undergoing laryngopharyngeal surgery,all of them were laryngeal cancer.Among the 12 patients with vocal cord structure shown by ultrasound,9 had fixed vocal cords on one side before surgery,and they were correctly diagnosed by ultrasound.In addition,ultrasound suggested that 2 patients had airway stenosis and weakened vocal cord movement,and laryngoscopy could not peer into the vocal cord plane due to airway stenosis.The results of 40 patients with vocal cord movements showed high consistency between transcervical ultrasound and laryngoscopy(Kappa=0.826,P<0.001).Conclusion Transcervical ultrasound is a non-invasive examination method,which is highly consistent with laryngoscopy in evaluating the vocal cord movements in some patients.It is simple and easy to operate,without special preparation for patients or painless in the examination process,which has clinical application value.
作者
王东林
韩丽珍
刘术舟
何珂
陈树宝
WANG Dong-lin;HAN Li-zhen;LIU Shu-zhou;HE Ke;CHEN Shu-bao(Department of Ultrasound,Hainan General Hospital,Haikou 570311,Hainan,CHINA;Department of Medical Record Management,Hainan General Hospital,Haikou 570311,Hainan,CHINA;Department of Throat,Head,and Neck Surgery,Hainan General Hospital,Haikou 570311,Hainan,CHINA)
出处
《海南医学》
CAS
2024年第12期1762-1765,共4页
Hainan Medical Journal
基金
海南省自然科学基金(编号:821RC755)。
关键词
甲状腺
喉癌
声带
超声
喉镜
运动异常
喉返神经
Thyroid
Laryngeal cancer
Vocal cord
Ultrasound
Laryngoscopy
Abnormal movement
Recurrent laryngeal nerve
