甲状腺癌术中喉返神经监测

目的 探讨喉返神经监测在甲状腺癌术中的运用及临床意义.方法 对2011年10月至2012年5月200例甲状腺癌患者作回顾性分析,其中喉返神经监测组（A组）100例（145根喉返神经）,非喉返神经监测组（B组）100例（150根喉返神经）.结果 A组神经全程显露时间短于B组（10.5 min vs15.3 min,P＜0.01）;A组手术时间略短于B组,但差异无统计学意义（78.5 min vs 82.3 min,P＞0.05）;A、B组暂时性声带麻痹患者分别为5例、11例（P＜0.05）;A、B组永久性声带麻痹患者分别为1、0例（P＞0.05）.结论 甲状腺癌手术中运用神经监测技术有助于喉返神经的快速识别与保护,也可降低暂时性喉返神经麻痹的发生率.

Intraoperative neuromonitoring of the recurrent laryngeal nerve during thyroid cancer surgery

Objective To explore the clinical significance of intraoperative neuromonitoring （IONM）of recurrent laryngeal nerve （RLN） during thyroid cancer surgery.Methods 200 patients undergoing thyroid cancer surgery from Oct.2011 to May 2012 were retrospectively reviewed.The 200 patients were divided into 2 groups：100 patients in group A with IONM and 100 patients in group B without IONM.Results Group A had less RLN exposure time than group B（10.5 vs 15.3 mins,P ＜0.01）.Group A had shorter operation time than group B （78.5 vs 82.3 mins）.The difference had no statistical significance （P ＞ 0.05）.Transient RLN palsy occurred to 5 cases in group A and 11 cases in group B（P＜0.05）.Permanent RLN palsy occurred to 1 case in group A.No one in groupB had permanent RLN palsy （P ＞ 0.05）.Conclusions IONM can reduce the incidence of transient RLN palsy compared with visualization alone.It is an effective procedure for identifying and protecting RLN in thyroid cancer surgery.