喉返神经实时监测技术在再次甲状腺手术中的临床应用

Application of intraoperative neuromointoring of recurrent laryngeal nerve monitoring technology in reoprative thyroid surgery

目前,甲状腺手术在临床中普遍开展。由于术前或术中误诊,手术范围不规范,肿瘤复发等因素,导致部分患者需行再次手术治疗。再次手术中因前次手术瘢痕粘连和解剖结构紊乱等原因,使喉返神经(recurrent laryngeal nerve,RLN)损伤风险增加。术中神经监测技术(intraoperative neuromointoring,IONM)是应用神经电生理原理监测术中处于危险状态的神经系统功能的完整性的一项技术,可更好地辨认、预警喉返神经损伤,发现损伤部位,降低再次甲状腺手术中喉返神经损伤的几率。

At present, thyroid surgery is widely carried out during clinical practice. Because of preoperative or intraoperative misdiagnosis, nonstandard scope of operation, tumor recurrence and other factors, resulting in some cases needed to treat again. Due to the previous surgical scar adhesion and disordering of anatomical structure, the risk of injury of recurrent laryngeal nerve （RLN）increased manyfold. Intraoperative neuromointoring（IONM） is a technology for monitoring the functional integrity of the nervous system in state of dangerous by neural electrophysiological means. Better than the naked eye to identify and prompt the recurrent laryngeal nerve injury, to find the site of injury, IONM can significantly reduce the chance of transient RLN injury during thyroid reoperation as a sharp weapon to protect RLN.