术中神经监测信号丢失对全切甲状腺手术决策的影响-中西方观点异同

The influence of loss of intraoperative nerve monitoring signal on decision-making of total thyroidectomy: similarities and differences between Chinese and western perspectives

随着甲状腺术中神经监测(intraoperative nerve monitoring,IONM)技术的推广普及,术中对神经功能的判定成为可能,为手术决策提供了循证依据。术中神经肌电信号丢失(loss of nerve signal,LOS)常提示术后声带运动障碍。术中一旦发生LOS,术者进一步采取何种手术策略,国内专家和西方学者对此一直存在争议。本文通过调研国内外文献,对比分析国内专家和西方学者的观点差异及可能的原因。旨在为甲状腺手术决策提供理论依据。

With the popularization of intraoperative nerve monitoring(IONM),it is possible to determine the intraoperative nerve function,which provides evidence-based basis for surgical decision making.Intraoperative loss of nerve signal(LOS)often indicates postoperative vocal cord dyskinesia.Once LOS occurs intraoperatively,the next surgical strategy adopted by the operator has always been controversial among Chinese and western experts.Therefore,this paper makes a comparative analysis of the differences between the viewpoints of domestic experts and western scholars and the possible causes through the investigation of domestic and foreign literature to provide theoretical basis for better thyroid surgery decision.