不同类型主动脉杂交手术后喉返神经损伤的发生情况对比  

Comparison of the occurrence of recurrent laryngeal nerve injury after different types of aortic hybrid surgery

作　　者：黄鑫 刘媛[1] 任思瑶 李海洋[1] Huang Xin;Liu Yuan;Ren Siyao;Li Haiyang(The Third Ward,Coronary Heart Disease Surgery Center,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院冠心病外科中心三区,北京100029

出　　处：《中国医药》2025年第5期668-672,共5页China Medicine

基　　金：国家自然科学基金(82070483);北京市医院管理中心临床技术创新项目(XMLX202107)。

摘　　要：目的 对比不同类型主动脉杂交手术后喉返神经损伤的发生情况。方法 选取2019年12月至2021年12月在首都医科大学附属北京安贞医院行主动脉杂交手术(主动脉分支人工血管转流手术+胸主动脉腔内修复术)的患者175例,分析主动脉杂交术后喉返神经损伤的原因。对比分析不同手术种类患者术后喉返神经损伤及其他术后并发症的发生情况。结果 175例患者根据手术种类可分为左颈总动脉-左锁骨下动脉转流组(77例)、左腋动脉-右腋动脉转流组(35例)、左腋动脉-右腋动脉-右颈总动脉转流组(20例)和升主动脉-头臂血管转流组(43例),4组患者术后喉返神经损伤发生率分别为16.9%(13/77)、0(0/35)、10.0%(2/20)、18.6%(8/43),组间比较差异有统计学意义(P=0.023)。175例患者术后另发生脑梗死6例(3.4%)、截瘫5例(2.9%)、急性肾损伤3例(1.7%)、心律失常3例(1.7%)、肺部感染5例(2.9%)。结论 喉返神经损伤是主动脉杂交手术术后并发症之一,不同类型杂交手术患者间喉返神经损伤发生率有明显差异。Objective To compare the occurrence of recurrent laryngeal nerve injury after different types of aortic hybrid surgery.Methods A total of 175 patients who underwent aortic hybrid surgery(aortic branch artificial vascular bypass surgery + thoracic aortic endovascular repair) in Beijing Anzhen Hospital,Capital Medical University from December 2019 to December 2021 were selected to analyze the causes of recurrent laryngeal nerve injury after aortic hybrid surgery.The occurrence of postoperative recurrent laryngeal nerve injury and other postoperative complications in different surgical types were compared and analyzed.Results According to the type of surgery,the 175 patients were divided into the left common carotid artery-left subclavian artery bypass group(77 cases),the left axillary artery-right axillary artery-right carotid artery bypass group(35 cases),the left axillary artery-right axillary artery-right common carotid artery bypass group(20 cases),and the ascending aorta-brachiocephalic artery bypass group(43 cases).The incidence of postoperative recurrent laryngeal nerve injury in the four groups was 16.9%(13/77),0(0/35),10.0%(2/20) and 18.6%(8/43),respectively,and the difference between the groups was statistically significant(P=0.023).Another 175 patients had cerebral infarction in 6 cases(3.4%),paraplegia in 5 cases(2.9%),acute kidney injury in 3 cases(1.7%),arrhythmia in 3 cases(1.7%),and pulmonary infection in 5 cases(2.9%).Conclusion Recurrent laryngeal nerve injury is one of the postoperative complications of aortic hybrid surgery.There are significant differences in the incidence of recurrent laryngeal nerve injury among different types of hybrid surgery.

关 键 词：主动脉杂交术 喉返神经 危险因素 

分 类 号：R654.3[医药卫生—外科学]