中央区淋巴结清扫术中局部注射地塞米松对术后声嘶发生的临床研究

Clinical Study of Local Injection of Dexamethasone During Central Lymph Node Dissection on the Occurrence of Hoarseness After Operation

目的探讨中央区淋巴结清扫术中在喉返神经周围注射地塞米松对其功能影响。方法对湖北医药学院附属东风医院2018年3月至2020年3月甲状腺癌患者行中央区淋巴结清扫术108例患者随机分为两组,实验组49例在行全甲状腺切除+中央区淋巴结清扫术中在喉返神经周围注射地塞米松注射液,对照组59例则在喉返神经周围注射生理盐水,然后术后比较两组患者术后发音情况。结果实验组暂时性声音嘶哑发生率低于对照组(P<0.05),重度声嘶的发生率也低于对照组,且其恢复时间少于对照组(P<0.05);永久性声嘶二者无显著差异(P>0.05)。结论在中央区淋巴结清扫术中局部使用地塞米松对喉返神经功能有保护作用。

Objective To explore the effect of the dexamethasone administered locally on the function of recurrent laryngeal nerve in the central lymph node dissection.Methods A total of 108 patients with thyroid carcinoma who underwent central lymph node dissection in Dongfeng Hospital Affiliated to Hubei University of Medicine from March 2018 to March 2020 were randomly divided into two groups.49 patients in the experimental group were injected dexamethasone around the recurrent laryngeal nerve during total thyroidectomy and central lymph node dissection,while 59 patients in the control group were injected normal saline around the recurrent laryngeal nerve.Then the postoperative pronunciation of the two groups was compared.Results The incidence of temporary hoarseness in the experimental group was lower than that in the control group(P<0.05),the incidence of severe hoarseness in the experimental group was also lower than that in the control group,and the recovery time was shorter than that in the control group(P<0.05).There was no significant difference between permanent hoarseness and hoarseness(P>0.05).Conclusion Local administration of dexamethasone during central lymph node dissection has a protective effect on recurrent laryngeal nerve function.