甲状腺癌术中神经监测对预防喉返神经损伤的评估

Intraoperative neural monitoring in thyroid cancer operation for prevention of recurrent laryngeal nerve injury

目的探讨术中神经监测（intraoperative neural monitoring，IONM）对甲状腺癌术中喉返神经损伤的预防效果。方法中国医科大学附属盛京医院2011年6月至2013年6月收治的288例甲状腺癌，据是否采用IONM分为观察组（140例）和对照组（148例），评估2组的喉返神经损伤的发生率。结果观察组（0．67％）的喉返神经损伤率低于对照组（3．57％），有明显降低趋势，且手术时间较后者短（P〈0．001），2组的手术出血量及平均住院时间比较差异无统计学意义（P〉0．05）。结论IONM全程显露喉返神经有利于缩短手术操作时间及减少喉返神经损伤的发生率。

Objective To investigate intraoperative neural monitoring（IONM） for prevention of recurrent laryngeal nerve injury（RLN） during thyroid cancer operation. Methods 288 cases of thyroid cancer admitted from Jun. 2011 to Jun. 2013 in our hospital were studied and they were divided into the observation group（ 140 cases） and the control group（ 148 cases）according to whether IONM was used during surgery. The incidence of RLN injury was compared between the 2 groups. Results The injury rate of RLN was lower in the observation group（0. 67% ） than in the control group（3.57% ）and the operation time is shorter than the latter（P 〈0. 001 ）. There was no statistical difference for the operative bleeding volume and the average hospitalization time between the 2 groups （P 〉 0. 05）. Conclusion INOM can help to shorten the operation time and reduce the incidence of RLN injury.