喉返神经监测在甲状腺及甲状旁腺手术中的应用现状

doi:10.3969/j.issn.1006-7795.2017.04.026

摘要/Abstract

摘要： 喉返神经损伤是甲状腺及甲状旁腺手术中不可忽视的合并症，其损伤可能导致声音嘶哑及呼吸困难，严重影响病人生活质量，甚至危及生命。术中喉返神经监测技术目前作为保护喉返神经的有效办法，经历了从有创电极到无创性气管插管表面电极的发展。目前，国际和国内均提出了喉返神经监测的标准化步骤，再发展到连续神经监测和标准化的喉上神经监测，为辨认神经和防止神经损伤提供了新的手段，同时对喉返神经损伤机制的探究也更加深入。术中喉返神经监测技术的应用，可以帮助手术医师更好地辨认喉返神经，从而降低神经损伤的风险；同时对手术方式的优化、是否采用分期手术以及年轻外科医生的成长方面，具有重要意义。

关键词: 术中喉返神经监测, 甲状腺, 甲状旁腺, 手术

Abstract: The recurrent laryngeal nerve(RLN) injury is one of the important complications during the thyroid and parathyroid surgery, which can result in hoarseness and dyspnea. Intraoperative neuromonitoring (IONM) of recurrent laryngeal nerve has already become the effective method to protect the recurrent laryngeal nerve during the thyroid and parathyroid surgery, which has developed from invasive electrode to noninvasive endotracheal intubation with electrode, and standardized procedures of IONM was proposed. Furthermore, the continuous intraoperative neuromonitorying (C-IONM) and the standardized monitoring procedure of external branch of superior laryngeal nerve (EBSLN) has been accepted by an increasing number of surgeons. The probable damage mechanisms are gradually demonstrated through IONM. It is an effective technique that IONM could be to assist surgeons to recognize RLN and reduce the risk of recurrent laryngeal nerve injury during thyroid or parathyroid surgery, especially in complicated operations and reoperations.It will be of great importance in the aspect of improving the operation procedure, making staged secondary/completion procedure strategy, and the development of low-volume surgeons.

Key words: intraoperative recurrent laryngeal nerve neuromonitoring, thyroid, parathyroid, surgery

中图分类号:

R653

凌煜玮, 康骅. 喉返神经监测在甲状腺及甲状旁腺手术中的应用现状[J]. 首都医科大学学报, 2017, 38(4): 626-630.

Ling Yuwei, Kang Hua. Role of intraoperative neuromonitoring of recurrent laryngeal nerve in thyroid and parathyroid surgery[J]. Journal of Capital Medical University, 2017, 38(4): 626-630.

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