分阶段康复治疗对甲状腺术后暂时性声带功能损伤恢复的临床疗效

Clinical effect of staged rehabilitation therapy on recovery of temporary vocal cord function injury after thyroid surgery

目的 探讨因甲状腺癌手术造成声带功能损伤患者的分阶段康复方案。方法 将上海市瑞金康复医院2019年10月—2021年10月期间收治的88例因甲状腺手术造成声带功能损伤患者,随机分为康复组(分阶段康复治疗)44例与常规组(不给予特殊康复干预)44例,比较两组术后1~6 m声带运动功能与主观噪音恢复情况。结果 康复组干预后3 m、4 m、5 m声带功能达到2级患者比例(65.91%、93.18%、100.00%)高于常规组(31.82%、72.73%、77.27%)(χ^(2)=13.447,P=0.001;χ^(2)=7.110,P=0.029;χ^(2)=9.138,P=0.003);康复组干预2 m(21.47±4.97)、3 m(13.27±5.22)、4 m(6.86±3.82)、5 m(4.57±2.48)康复组简化嗓音障碍指数低于常规组(25.35±3.84、21.58±5.62、12.83±5.83、11.47±2.96)(t=4.098、7.187、5.682、11.852,均P<0.001)。结论 甲状腺手术造成声带功能损伤患者采用分阶段康复治疗,可促进声带功能尽快恢复,改善患者声音质量。

Objective To explore a phased rehabilitation program for patients with vocal cord function injury caused by thyroid surgery.Methods Totally 88 patients with vocal cord function injury caused by thyroid surgery were randomly divided into the rehabilitation group(receiving staged rehabilitation treatment)(44 cases) and the conventional group(without special rehabilitation intervention)(44 cases).The recovery of vocal cord motor function and subjective noise within 1~6 m after surgery was compared between the two groups.Results After intervention, the proportion of patients(65.91%, 93.18%, 100.00%) with 3 m, 4 m, 5 m vocal cord function reaching grade 2 in rehabilitation group was higher than that in conventional group(31.82%, 72.73%, 77.27%)(χ^(2)=13.447, P=0.001;χ^(2)= 7.110, P=0.029;χ^(2)=9.138, P=0.003);The simplified voice disorder index of the rehabilitation group was lower than that of the normal group(25.35±3.84, 21.58±5.62, 12.83±5.83, 11.47±2.96) after 2 m(21.47±4.97), 3 m(13.27±5.22), 4 m(6.86±3.82) and 5 m(4.57±2.48) intervention(t=4.098, 7.187, 5.682, 11.852, all P<0.001).Conclusion In patients with vocal cord function injury caused by thyroid surgery, phased rehabilitation can promote the vocal cord function recovery as soon as possible and improve the voice quality of patients.