腔镜下甲状腺次全切除术中应用超声刀显露喉返神经的神经保护效果

Neuroprotective efficacy of recurrent laryngeal nerve exposure with ultrasonic knife in endoscope subtotal thyroidectomy

目的观察腔镜下甲状腺次全切除术中应用超声刀显露喉返神经的神经保护效果。方法行腔镜下甲状腺次全切除术的患者120例随机均分为两组,术中分别采用超声刀显露喉返神经(A组)和不显露喉返神经(B组),比较喉返神经损伤情况。结果 A组手术时间为(120.3±11.9)min,长于B组的(103.6±11.2)min(P<0.05)。A组发生喉返神经损伤1例(1.67%),术后2个月余完全恢复。B组发生喉返神经损伤7例(11.67%),完全恢复2例,部分恢复4例,1例未恢复。A组喉返神经损伤发生率低于B组(P<0.05)。结论虽然腔镜下甲状腺次全切除术中暴露喉返神经增加手术时间,但可有效降低喉返神经损伤的发生。

Objective To observe the neuroprotective efficacy of recurrent laryngeal nerve （RLN） exposure with ultrasonic knife in endoscope subtotal thyroidectomy. Methods A total of 120 patients undergoing endoscope subtotal thyroidectomy was randomly and equally assigned into two groups of A（RLN exposure with ultrasonic knife in operation） and B（without RLN exposure）. The incidence of RLN injury was compared. Results The operation time was longer in group A than that in group （120. 3±11.9） min vs. （103.6±11.2） min]（P〈0. 05）. The incidence rate of RLN injury was lower in group A than that in group B（1.67% vs. 11.67%） （P〈0. 05）. The injured RLN in goup A was recovered two months later. Of 7 cases with RLN injury in group B, 2 cases recovered completely,4 eases recovered partially and 1 case did not recover. Conclusion RLN exposure with ultrasonic knife in endoscope subtotal thyroidectomy can effectively reduce the incidence of RLN injury although operation time is prolonged.