甲状腺癌术后患者喉返神经损伤的危险因素分析  

Risk Factors Analysis of Recurrent Laryngeal Nerve Injury in Thyroid Cancer Patients after Surgery

作　　者：高登旺[1] GAO Dengwang(Department of Orthopedic Surgery,The Third People's Hospital of Jinan,Jinan 250000,China)

机构地区：[1]山东省济南市第三人民医院甲乳外科,山东济南250000

出　　处：《中国伤残医学》2024年第18期40-43,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨甲状腺癌患者术后出现喉返神经损伤(RLN)的危险因素。方法:回顾性分析2021年6月-2024年5月济南市第三人民医院收治的86例甲状腺癌患者的临床资料,根据是否出现喉返神经损伤分为发生组(n=14)与未发生组(n=72)。比较两组患者一般资料与临床诊治相关信息的差异性,另对患者发生损伤的危险因素进行分析。结果:两组非首次手术占比、手术范围、显露RLN情况、RLN分离方式与操作原则比较,差异均有统计学意义(P<0.05)。结果显示,手术范围为“广泛”(OR=6.862,P=0.018)、非首次手术(OR=8.489,P=0.012)、RLN分离方式为“自甲状腺下角”(OR=7.409,P=0.015)、操作原则为“非精细化被膜解剖法”(OR=5.930,P=0.009)是甲状腺癌手术患者RLN损伤发生的危险因素。结论:在甲状腺癌患者手术期间,应重视非首次手术占比、手术范围、显露RLN情况、RLN分离方式与操作原则等危险因素,采取有效的预防措施,降低损伤的发生率。Objective:To investigate the risk factors of recurrent laryngeal nerve injury(RLN)in patients with thyroid cancer after surgery.Methods:The clinical data of 86 patients with thyroid cancer admitted to Jinan Third People's Hospital from June 2021 to May 2024 were retrospectively analyzed.According to whether recurrent laryngeal nerve injury occurred,they were divided into an occurrence group(n=14)and a non-occurrence group(n=72).The difference of general data and clinical diagnosis and treatment information between the two groups was compared,and the risk factors of injury were analyzed.Results:There were statistically significant differences in the proportion of non-first operation,operation scope,RLN exposure,RLN separation method and operation principle between the two groups(P<0.05).The results showed that the operation scope was"extensive"(OR=6.862,P=0.018),nonfirst operation(OR=8.489,P=0.012),RLN separation method was"from the inferior thyroid angle"(OR=7.409,P=0.015),and the operating principle was"non-fine capsular dissection"(OR=5.930,P=0.009)is a risk factor for RLN injury in patients undergoing surgery for thyroid cancer.Conclusion:During the operation of thyroid cancer patients,risk factors such as the proportion of nonfirst operation,the scope of operation,the exposure of RLN,the way of RLN separation and the principle of operation should be paid attention to,and effective preventive measures should be taken to reduce the incidence of injury.

关 键 词：甲状腺癌 喉返神经损伤 手术风险 危险因素 

分 类 号：R736.1[医药卫生—肿瘤]