关键词: 甲状腺手术, 神经检测, 喉返神经

Abstract: ［Abstract］ Objective To investigate the effects of intraoperative nerve monitoring on earlyreoperation of residual thyroid after 5 to 15 days of thyroidectomy for thyroid cancer，and the level of postoperative serum thyroglobulin， recurrent laryngeal nerve injury and parathyroid gland function. Methods We retrospectively analyzed the data of a group of patients with thyroid surgery from January 2010 to December 2016 in Sun Yat?sen Memorial Hospital of Sun Yat?sen University. The patients who met the inclusion criteria were assigned to the nerve monitoring group and the non-neural monitoring group according to whether the nerve monitoring was used during the operation. The postoperative temporary and permanent recurrent laryngeal nerve injury were recorded. The hypoparathyroidism，the 435 patients who met the inclusion criteria，including 227 in the nerve monitoring group and 208 in the non? neural monitoring group. The average preoperative serum Tg concentration in the nerve monitoring group was 18.66±2.3 ng/ml，and 17.43±1.4 ng/ml in the non?neural，which was not statistically significant（P<0.05）. Temporary hoarseness occurred in 18 cases（18/208，8.67%）in the non? neural monitoring group，and in 5 cases （5/227，2.2%）in the nerve monitoring group（P<0.05）. Non?neural monitoring group had permanent hoarseness in 4 cases（4/208，1.92%），and in one case（1/227，0.44%）in the nerve monitoring group（P>0.05）. Thirty?eight cases（39/208，18.75%）in non?neural monitoring group had transient hypoparathyroidism，and 17 cases（17/227，7.49%）in the nerve monitoring group（P< 0.05）；Four cases（4/208，1.92%）in non?neural monitoring group had permanent hypoparathyroidism， and two（2/227，0.88%）in the nerve monitoring group（P>0.05）. The average Tg concentration in the non?neural monitoring group was 2.82±0.2 ng/ml in 1 month after operation，and 1.37±0.2 ng/ml in the nerve monitoring group（P<0.05）. In the non? neural monitoring group，45.06%（94/208）patients had an average Tg concentration of less than 1 ng/ml at 1 month postoperatively，and 67.4%（153/227）in the nerve monitoring group （P<0.05）. Conclusion Intraoperative nerve monitoring for reoperation of residual thyroid after 5 days to 15 days of thyroidectomy in thyroid cancer patient can reduce the recurrent laryngeal nerve injury and hypoparathyroidism，improve the thoroughness of improving the thoroughness of thyroidectomy and cancer tissue resection.

Key words: nerve monitoring, thyroid surgery, recurrent laryngeal nerve