武警医学
武警醫學
무경의학
MEDICAL JOURNAL OF THE CHINESE PEOPLE'S ARMED POLICE FORCES
2015年
1期
16-18
,共3页
王军%李玉锋%孙松%路旭
王軍%李玉鋒%孫鬆%路旭
왕군%리옥봉%손송%로욱
甲状腺切除术%喉返神经%神经损伤%队列研究
甲狀腺切除術%喉返神經%神經損傷%隊列研究
갑상선절제술%후반신경%신경손상%대렬연구
thyroidectomy%recurrent laryngeal nerve%nerve injury%cohort study
目的:探讨甲状腺手术暴露与非暴露术式对喉返神经的保护作用。方法采用前瞻性队列研究的方法,根据是否暴露将我科行甲状腺手术327例分为喉返神经暴露组与非暴露组。主要终点事件为喉返神经损伤的发生率,随访至术后6个月。结果完整随访307例。喉返神经损伤发生率3.2%。按组分析,喉返神经暴露组,喉返神经损伤率3.0%,其中永久性损伤1例(0.61%),暂时性损伤4例(2.42%);喉返神经非暴露组,喉返神经损伤率3.5%,其中永久性损伤1例(0.70%),暂时性损伤4例(2.82%)。两组比较,喉返神经损伤发生率差异无统计学意义。结论常规暴露喉返神经并不增加损伤机会,鉴于腺叶切除在甲状腺手术中的作用越来越重要,应考虑常规显露喉返神经。
目的:探討甲狀腺手術暴露與非暴露術式對喉返神經的保護作用。方法採用前瞻性隊列研究的方法,根據是否暴露將我科行甲狀腺手術327例分為喉返神經暴露組與非暴露組。主要終點事件為喉返神經損傷的髮生率,隨訪至術後6箇月。結果完整隨訪307例。喉返神經損傷髮生率3.2%。按組分析,喉返神經暴露組,喉返神經損傷率3.0%,其中永久性損傷1例(0.61%),暫時性損傷4例(2.42%);喉返神經非暴露組,喉返神經損傷率3.5%,其中永久性損傷1例(0.70%),暫時性損傷4例(2.82%)。兩組比較,喉返神經損傷髮生率差異無統計學意義。結論常規暴露喉返神經併不增加損傷機會,鑒于腺葉切除在甲狀腺手術中的作用越來越重要,應攷慮常規顯露喉返神經。
목적:탐토갑상선수술폭로여비폭로술식대후반신경적보호작용。방법채용전첨성대렬연구적방법,근거시부폭로장아과행갑상선수술327례분위후반신경폭로조여비폭로조。주요종점사건위후반신경손상적발생솔,수방지술후6개월。결과완정수방307례。후반신경손상발생솔3.2%。안조분석,후반신경폭로조,후반신경손상솔3.0%,기중영구성손상1례(0.61%),잠시성손상4례(2.42%);후반신경비폭로조,후반신경손상솔3.5%,기중영구성손상1례(0.70%),잠시성손상4례(2.82%)。량조비교,후반신경손상발생솔차이무통계학의의。결론상규폭로후반신경병불증가손상궤회,감우선협절제재갑상선수술중적작용월래월중요,응고필상규현로후반신경。
Objective To determine the protective effect of exposing the recurrent laryngeal nerve ( RLN) during thyroidecto-my.Metholds This is a perspective cohort study .The patients, admitted between January 2007 and December 2010, were divided into two groups according to whether exposed the RLN .The main end point was the incidence of RLN injury within 6 months. Results 327 patients were included in this study , with the follow-up more than 6 months in 307 patients.The incidence of RLN injury was 3.2%.The incidence of RLN injury in exposing and non-exposing groups was 3.0%(temporary 2.42%, permanent 0.61%) and 3.5%( temporary 2.82%, permanent 0.70%), respectively.There was no significant difference between these two groups . Conclusions RLN exposure leads no increase in the incidence of RLN injury .Exposure of the RLN should be routinely done in the era of lobectomy.