入喉处解剖暴露喉返神经在甲状腺腺叶切除术中的应用价值及安全性研究

doi:10.3969/j.issn.1001-8131.2023.05.005

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摘要目的探讨入喉处暴露喉返神经对甲状腺叶切除术中的应用效果。方法挑选94例行甲状腺叶切除术者,依照随机数字表法分为对照组和试验组,各47例。对照组选取甲状腺动脉下方暴露,试验组使用入喉处解剖暴露喉返神经。对比2组围术期指标、甲状腺功能[甲状腺素（T4）、游离甲状腺素（FT4）、甲状旁腺素（PTH）]、声带功能[基频、谐波造成比（HNR）、标准化噪声能量（NNE）]、并发症发生率变化。结果与对照组比较,试验组操作时间、住院天数短,且术中出血少,术后1d疼痛评分低（P<0.05）;与对照组比较,术后3d试验组FT4、PTH、T4水平较高（P<0.05）;与对照组比较,术后1个月试验组基频、NNE较低,且HNR较高（P<0.05）;试验组并发症发生率8.51%（4/47）较对照组25.53%（12/47）低（P<0.05）。结论入喉处暴露喉返神经对甲状腺叶切除术中疗效显著,可以改善围术期指标,改善甲状腺功能和声带功能,且其能降低并发症发生率,值得临床进一步推广应用。

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	李会力
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关键词 ：甲状腺腺叶切除术, 入喉处解剖暴露喉返神经, 甲状腺功能

Abstract：Objective To investigate the applicationeffect of exposing recurrent laryngeal nerve at the laryngeal entrance in thyroid lobectomy.Methods A total of 94 case patientswho underwent thyroidlobectomy were selected and divided into a control group and an experimental group according to the random number table method,with 47 cases in each group.The control group was exposed below the thyroid artery,while the experimental group exposed the recurrent laryngeal nerve at the laryngeal entrance.The changes of perioperative indexes,thyroid function [thyroxine（T4）,free thyroxine（FT4）,parathyroid hormone（PTH）],vocal cord function[fundamental frequency,harmonic generation ratio（HNR）,normalized noise energy（NNE）],and the incidence of complications of the two groupswere compared.Results Compared with the control group,the operation time and hospitalization time of the experimental group were shorter,the amount of intraoperative blood loss was less,and the pain score on the first day after operationwas lower（P<0.05）;Compared with the control group,the levels of FT4,PTH and T4 in the experimental group3 days after operation were higher（P<0.05）;Compared with the control group,the fundamental frequency and NNE of the experimental group one month after operation were lower,and the HNR was higher（P<0.05）;The complication rate of the the experimental group 8.51%（4/47）was lower than that of the control group 25.53%（12/47）（P<0.05）.Conclusion Anatomical exposure of the recurrent laryngeal nerve into the larynx has a significant effect in thyroid lobectomy,which can improve the perioperative indicators,improve the thyroid function and vocal cord function,and can reduce the incidence of complicatios.It is worthy of further clinical application.

Key words： Thyroid lobectomy Dissecting and exposing recurrent laryngeal nerve at the laryngeal entrance thyroid function

收稿日期: 2022-09-29

PACS:

R581

引用本文:

李会力, 孔伟博, 常勇科. 入喉处解剖暴露喉返神经在甲状腺腺叶切除术中的应用价值及安全性研究[J]. 哈尔滨医药, 2023, 43(5): 12-14.
Li huili, Kong weibo, Chang yongke. Application Value and Safety of Dissecting and Exposing the Recurrent Laryngeal Nerve at the Entrance To the Larynx in Thyroid Lobectomy. journal1, 2023, 43(5): 12-14.

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http://www.hrbyybjb.org.cn/CN/10.3969/j.issn.1001-8131.2023.05.005 或 http://www.hrbyybjb.org.cn/CN/Y2023/V43/I5/12

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