喉返神经显露在经口全腔镜甲状腺手术中的应用价值  

Application Value of Recurrent Laryngeal Nerve Exposure in Peroral Total Endoscopic Thyroidectomy

作　　者：万钧 李财胜 周小青 杨斌 叶斌 WAN Jun;LI Caisheng;ZHOU Xiaoqing;YANG Bin;YE Bin(The Second Affiliated Hospital of Gannan Medical College,Ganzhou 341000,China;不详)

机构地区：[1]赣南医学院第二附属医院,江西赣州341000

出　　处：《中国医学创新》2023年第16期57-60,共4页Medical Innovation of China

基　　金：赣州市指导性科技计划项目(GZ2021ZSF125)。

摘　　要：目的:探讨喉返神经显露在经口全腔镜甲状腺手术中的应用价值,以期为减少术后并发症提供一种可靠的手术入路。方法:选取赣南医学院第二附属医院2021年1月-2022年4月接收的40例经口全腔镜甲状腺手术患者,将符合入组标准的患者根据是否解剖喉返神经分成对照组和观察组,各20例。其中对照组不解剖喉返神经切除甲状腺叶,观察组解剖显露喉返神经后切除甲状腺叶,对比两组术后声音有无嘶哑、嘶哑轻重程度及声音恢复时间,记录两组手术时间、术中出血量、术后创面恢复时间、住院时间及创面出血情况,并对其术后喉返神经损伤情况进行客观性评价。结果:观察组声音嘶哑发生率显著低于对照组(P<0.05),日本言语语音学会(Japanese society for logopedics and phoniatrics)嗓音嘶哑评估GRBAS分级情况优于对照组(P<0.05),且声音恢复时间短于对照组(P<0.05);观察组术中出血量多于对照组、手术时间明显长于对照组(P<0.05),术后创面出血量少于对照组(P<0.05),观察组术后创面恢复时间及住院时间均明显短于对照组(P<0.05);两组喉返神经损伤总发生率比较,差异有统计学意义(P<0.05)。结论:喉返神经显露在经口全腔镜甲状腺手术中能发挥较好的临床效果,其不仅能保护患者喉返神经,降低声音嘶哑发生率,还能缩短住院时间,促进患者康复,可在甲状腺手术中推广使用。Objective:To investigate the application value of recurrent laryngeal nerve exposure in peroral total endoscopic thyroidectomy,so as to find a reliable surgical approach to reduce postoperative complications.Method:A total of 40 patients who underwent peroral total endoscopic thyroidectomy in the Second Affiliated Hospital of Gannan Medical College from January 2021 to April 2022 were selected.According to whether the recurrent laryngeal nerve was dissected or not,the patients were divided into the control group(thyroid lobectomy without recurrent laryngeal nerve dissection)and observation group(thyroid lobectomy after recurrent laryngeal nerve dissection),with 20 cases in each group.The occurrence and severity of postoperative hoarseness and recovery time of voice were compared between the groups,the operation time,intraoperative blood loss,postoperative wound recovery time,length of hospital stay and wound bleeding were recorded,postoperative recurrent laryngeal nerve injury was objectively evaluated.Result:The incidence of hoarseness in the observation group was significantly lower than that in the control group(P<0.05),the GRBAS grading of hoarseness assessment proposed by Japanese society for logopedics and phoniatrics was better than that in control group(P<0.05),and recovery time of voice was shorter than that in control group(P<0.05).The amount of intraoperative bleeding in the observation group was more than that in the control group,operation time was significantly longer than that in the control group(P<0.05),the postoperative wound bleeding was less than that in the control group(P<0.05),postoperative wound recovery time and length of hospital stay in the observation group were significantly shorter than those in the control group(P<0.05).There was a statistically significant difference in the total incidence of recurrent laryngeal nerve injury between the two groups(P<0.05).Conclusion:Recurrent laryngeal nerve exposure can improve the effect of peroral total endoscopic thyroidectomy.It can not only p

关 键 词：喉返神经显露 全腔镜甲状腺手术 声音嘶哑 术后情况 

分 类 号：R653[医药卫生—外科学]