喉返神经监测仪在复杂甲状腺手术中的应用效果

Application effect of laryngeal recurrent nerve monitor in complicated thyroid surgery

目的探讨喉返神经监测仪在复杂甲状腺手术中的应用效果。方法回顾分析我院2014年1月～2018年2月完成的102例复杂甲状腺手术患者的病例资料,根据术中是否使用喉返神经监测仪显露喉返神经,分为术中神经监测(IONM)组(48例)与非IONM组(54例),按术中涉及的喉返神经数量计算其损伤率,比较两组的喉返神经损伤率、手术时间、喉返神经显露时间、术中出血量、住院总费用及麻醉时间。结果喉返神经监测仪干预后,IONM组暂时性喉返神经损伤率低于非IONM组,差异有统计学意义(P<0.05);两组均无永久性喉返神经损伤;IONM组手术时间及喉返神经显露时间短于非IONM组,术中出血量少于非IONM组,住院费用高于非IONM组,差异均有统计学意义(P<0.05);两组的麻醉时间比较,差异无统计学意义(P>0.05)。结论喉返神经监测仪在复杂甲状腺手术中尤其再次手术时可降低暂时性喉返神经损伤率,有效缩短患者的手术时间、喉返神经显露时间及减少其出血量,值得推广使用。

Objective To explore the application effect of recurrent laryngeal nerve monitor in complicated thyroid surgery. Methods A retrospective analysis was made of 102 cases of complicated thyroid surgery case information in our hospital from January 2014 to February 2018, according to whether or not the recurrent laryngeal nerve monitor was used to expose the recurrent laryngeal nerve during operation, the patients were divided into intraoperative nerve monitoring (IONM) group (48 cases) and non-IONM group (54 cases), the injury rate was calculated according to the number of recurrent laryngeal nerves involved in the operation, the rate of recurrent laryngeal nerve injury, operation time, exposure time of recurrent laryngeal nerve, amount of bleeding during operation, total cost of hospitalization and anesthesia time were compared between the two groups. Results After intervention with recurrent laryngeal nerve (RLN) monitor, the rate of temporary RLN injury in IONM group was lower than that in non-IONM group, the difference was significant (P<0.05). There was no recurrent laryngeal nerve injury in both group. The operation time and exposure time of RLN in IONM group were shorter than that in non-IONM group, the amount of bleeding during operation was less than that in non-IONM group, and the hospitalization cost was higher than that in non-IONM group, the difference was statistically significant (P<0.05). There was no significant difference in anesthesia time between the two groups (P>0.05). Conclusion Recurrent laryngeal nerve monitor can reduce the rate of temporary recurrent laryngeal nerve injury in complicated thyroid surgery, especially in reoperation, it can effectively shorten the operation time, the exposure time of recurrent laryngeal nerve and reduce the amount of bleeding. It is worth popularizing.