甲状腺手术中应用类固醇激素保护喉返神经功能的研究  

Administration of corticosteroids during thyroidectomy to protect recurrent laryngeal nerve function

作　　者：时伟锋[1] 邹汉青[2] 

机构地区：[1]江南大学附属医院普通外科,江苏无锡214062 [2]苏州大学附属第二医院普通外科,江苏苏州215004

出　　处：《中国现代医学杂志》2015年第7期61-63,共3页China Journal of Modern Medicine

摘　　要：目的探讨在甲状腺手术中静脉应用类固醇激素以保护喉返神经功能的可行性。方法该院2010年1月-2011年8月226例甲状腺手术患者分为两组。其中,实验组105例,对照组121例。实验组手术开始后及手术后两天连续经静脉给予氢化可的松100 mg/d,对照组无特殊处理。手术前后喉镜检查观察声带活动情况,评价主观发音质量改变,并记录喉返神经麻痹恢复时间。结果实验组共计显露152条喉返神经,手术后暂时性喉返神经损伤3例,平均恢复时间(19.33±11.59)d,对照组共计显露174条喉返神经,手术后暂时性喉返神经损伤5例,平均恢复时间(99.00±36.12)d,两组喉返神经损伤率差异无统计学意义,实验组暂时性神经损伤恢复时间统计学意义低于对照组,P=0.011。结论甲状腺手术中应用类固醇激素有利于缩短喉返神经暂时性损伤功能恢复时间。【Objective】To evaluate the availability of intraoperative corticosteroids during thyroidectomy to protect recurrent laryngeal nerve function. 【Methods】There were total 226 patients with thyroid disease who were divided into two groups（105 patients in experimental group vs. 121 patients in control group） from January 2011 to May 2012. All patients in experimental group received a dose of 100 mg hydrocortisone during and two days after thyroidectomy, while no corticosteroids were administered in control group. The laryngoscope was used pre and postoperatively, the pronunciation status was appraised and the mean time to recovery was recorded. 【Results】There were 152 recurrent laryngeal nerves at risk in the experimental group with 3 temporary and one permanent recurrent laryngeal nerve paralysis, while 174 recurrent laryngeal nerves were at risk in the control group with 5 temporary recurrent laryngeal nerve paralysis. No significant difference of recurrent laryngeal nerve paralysis was observed. The mean time to recovery was significantly shorter for patients received intraoperative steroids（19.33±11.59 vs. 99.00±36.12） days, P =0.011. 【Conclusions】Intraoperative administration of corticosteroids during thyroidectomy is helpful in recovery of temporary recurrent laryngeal nerve paralysis.

关 键 词：甲状腺 喉返神经 激素 

分 类 号：R653[医药卫生—外科学]