术中神经监测对分化型甲状腺癌再次手术中保护喉返神经的作用

Role of intraoperative nerve monitoring in protecting recurrent laryngeal nerve in differentiated thyroid carcinoma reoperation

目的探讨术中神经监测技术在分化型甲状腺癌再次手术中保护喉返神经的作用。方法回顾性分析2012年10月-2014年10月解放军总医院普通外科收治的92例分化型甲状腺癌再次手术并应用术中神经监测仪保护喉返神经的患者资料。结果所有手术均顺利完成,无术后出血、饮水呛咳及手足麻木发生。术中出现3例喉返神经肌电信号一过性异常。术后2例暂时性喉返神经损伤,未出现永久性喉返神经损伤。结论术中神经监测仪能协助术者在术中快速有效地发现喉返神经,降低喉返神经损伤发生率,值得在甲状腺再次手术中推广应用。

Objective To assess the value of intraoperative nerve monitoring in reoperation for differentiated thyroid carcinoma. MethodsClinical data about 92 patients who underwent differentiated thyroid carcinoma reoperation with intraoperative nerve monitoring from October 2012 to October 2014 in the department of general surgery of Chinese PLA General Hospital were retrospectively analyzed.Results All operations were successfully completed without any symptoms of postoperative bleeding, bucking or hand and foot numbness. The recurrent laryngeal nerve signal in 3 cases were temporarily abnormal. Two cases were found to have temporary recurrent laryngeal nerve injures and no permanent recurrent laryngeal nerve injury was found.Conclusion Intraoperative nerve monitoring can assist surgeons infinding recurrent laryngeal nerve quickly during operation and reducing rate of recurrent laryngeal nerve injury, which is worthy of being applied in surgery widely.