摘要
目的:分析喉返神经监测技术(recurrent laryngeal nerve-intraoperative neuromonitoring,RLN-IONM)在分化型甲状腺癌(differentiated thyroid cancer,DTC)中央区淋巴结清扫术(central lymph node dissection,CND)中的应用价值及对患者术后生活质量的影响。方法:根据手术方式进行分组,选取单侧接受TT联合CND治疗的113例患者为对照组,选取RLN-IONM下TT联合CND治疗的88例患者为观察组。回顾性分析所有患者的临床资料,对比两组手术相关情况、术后生活质量的变化情况。结果:观察组术中喉返神经(recurrent laryngeal nerve,RLN)暴露时间、中央区清扫时间均显著短于对照组,术中出血量低于对照组,差异均有统计学意义(P<0.05)。术后2周,观察组FACT-G-V4评分中生理状况、功能状况评分均低于对照组(P<0.05),而两组社会/家庭状况、情感状况比较,差异均无统计学意义(P>0.05)。术后1、3个月观察组RLN损伤、RLN暂时性损伤、抽搐麻木及声音嘶哑发生率均显著少于对照组(P<0.05)。结论:在DTC患者接受TT联合CND治疗中,RLN-IONM可有效缩短手术时间,降低术后并发症发生率,改善预后。
Objective:To analyze the application value of recurrent laryngeal nerve-intraoperative neuromonitoring(RLN-IONM)in central lymph node dissection(CND)for differentiated thyroid carcinoma(DTC)and its effect on postoperative quality of life.Method:According to the operation mode,113 DTC patients treated with TT combined with CND were selected as the control group,and 88 DTC patients treated with TT combined with CND under RLN-IONM were selected as the observation group.The clinical data of all patients were retrospectively analyzed,and the changes of operation related conditions,postoperative quality of life and serum related indicators in two groups were compared.Result:The exposure time of RLN and the cleaning time of central region in the observation group were shorter than those in the control group,the intraoperative blood loss was lower than that in the control group,there were statistically significant differences(P<0.05).At 2 weeks after operation,the physiological status and functional status scores of FACT-G-V4 in the observation group were lower than those of the control group(P<0.05),while there were no statistically significant differences in social/family status and emotional status between two groups(P>0.05).In addition,the incidence of RLN injury,RLN temporary injury,convulsion numbness and hoarseness in the observation group was significantly lower than that in the control group at 1 and 3 months after surgery(P<0.05).Conclusion:In DTC patients receiving TT combined with CND,RLN-IONM can effectively shorten the duration of surgery,reduce the incidence of postoperative complications,and improve the prognosis.
作者
唐杰东
TANG Jiedong(Guangzhou Panyu Central Hospital,Guangzhou 511400,China)
出处
《中国医学创新》
CAS
2020年第30期134-137,共4页
Medical Innovation of China
基金
广东省广州市番禺区科技计划项目(2018-Z04-66)。
关键词
喉返神经监测技术
分化型甲状腺癌
中央区淋巴结清扫术
生活质量
Recurrent laryngeal nerve-intraoperative neuromonitoring
Differentiated thyroid carcinoma
Central lymph node dissection
Quality of life
