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作 者:乔艳晶 QIAO Yanjing(Department of General Surgery,Xiangyin Township Health Center,Ningyang County,Tai'an City,Shandong Province,Tai'an 271400,)
机构地区:[1]山东省泰安市宁阳县乡饮乡卫生院外科,泰安271400
出 处:《中国医药指南》2024年第29期31-34,共4页Guide of China Medicine
摘 要:目的分析液体隔离带法和杠杆撬离法预防甲状腺微波消融术中喉返神经损伤的效果及安全性。方法将140例甲状腺良性结节手术患者纳入研究,病例均来源于本院2021年12月至2022年12月期间收治的住院患者。患者均接受微波消融术治疗,按照术中所采用预防保护措施的不同,将患者区分为观察组和对照组。其中对照组(n=70),术中应用液体隔离带法,观察组(n=70),术中应用杠杆撬离法。结果对照组微波消融时间、手术时间、住院天数均高于观察组(P<0.05);两组术后均出现一定的并发症,包括声音嘶哑和甲状旁腺损伤等,组间比较甲状旁腺损伤发生率与返喉神经损伤发生率差异情况,对照组均高于观察组(P<0.05);就饮水呛咳发生率、声音嘶哑发生率组间差异进行检验(P>0.05)。治疗后两组各项炎性因子水平较本组治疗前均出现一定的上升,但观察组治疗后的CRP、IL-6、TNF-α检测水平均低于同一时间点对照组(P<0.05)。经术后随访,两组均存在一定的结节残留情况,观察组的结节残留发生率为8.57%,对照组为10.00%(P>0.05)。结论甲状腺良性结节的微波消融术治疗中,杠杆撬离法在减少喉神经损伤与甲状旁腺损伤发生率方面具有较好的效果。Objective To analyze the effectiveness and safety of liquid isolation band method and lever detachment method in preventing recurrent laryngeal nerve injury during thyroid microwave ablation surgery.Methods A total of 140 patients with benign thyroid nodules who underwent surgery were included in the study,all of whom were hospitalized patients admitted to our hospital from December 2021 to December 2022.All patients received microwave ablation treatment,Patients were divided into observation group and control group according to the different preventive and protective measures adopted during operation.Among them,the control group(n=70)used liquid isolation band method during surgery,while the observation group(n=70)used lever detachment method during surgery.Results The microwave ablation time,operation time and hospitalization days of control group were higher than those of observation group(P<0.05).Both groups experienced certain postoperative complications,including hoarseness and parathyroid injury.The incidence of parathyroid injury and recurrent laryngeal nerve injury was compared between the groups,and the control group was significantly higher than the observation group(P<0.05).The differences in the incidence of choking on drinking water and hoarseness between groups were examined(P>0.05).After treatment,the levels of various inflammatory factors in both groups showed a certain increase compared to before treatment,but the levels of CRP,IL-6,and TNF-αin the observation group were significantly lower than those in the control group at the same time point(P<0.05).After postoperative follow-up,there were some residual nodules in both groups.The incidence of residual nodules in the observation group was 8.57%,the control group's was 10.00%(P>0.05).Conclusions In the microwave ablation treatment of benign thyroid nodules,the lever dissection method has a good effect in reducing the incidence of laryngeal nerve injury and parathyroid gland injury.
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