Abstract: 【Abstract】〓Objective〓To explore the clinical value of recurrent laryngeal nerve monitoring during thyroid re-operation. Methods〓NIM-Response 3.0 monitoring system was applied in 65 patients in the real-time monitoring group, and conventional exposure of RLN was implemented in 50 patients in the routine operative group. The temporary and permanent paralysis rates of RLN, time for RLN exposure, time for operation were compared between two groups. Results〓The temporary and permanent RLN injury rates in the real-time monitoring group was lower than the conventional exposure group(1.53% vs 8.0%,P<0.01; 0 vs 4.0%,<0.01). Moreover, the median time for RLN exposure and time for operation in patients of the real-time monitoring group were shorter than that of the routine operative group(5.56±1.95 mins vs 15.92±2.69 mins,P<0.01, t=-23.94;113.90±9.40 mins vs 132.40±21.40 mins,P<0.01, t=-6.23). Conclusion〓Intraoperative recurrent laryngeal nerve monitoring can reduce the temporary and permanent RLN injury rate and decreased the time for RLN exposure and operation for patients undergoing thyroid re-operation.

Key words: Re-operation, Intraoperative nerve monitoring, Paralysis, Recurrent laryngeal nerve, Thyroid

摘要： 【摘要】 目的 探讨喉返神经探测仪在甲状腺再次手术中的临床应用价值。方法〓65例患者采用采用美国Medtronic Xomed公司生产的NIM-Response 3.0行术中喉返神经监测,50例患者采用常规手术暴露喉返神经,比较两组患者在术后暂时性喉返神经损伤率、永久性喉返神经损伤率、确认喉返神经发现时间、手术操作时间的差异。结果〓暂时性喉返神经损伤率、永久性喉返神经损伤率在术中监测组的均要比常规手术低,为1.53% vs 8.0%(P<0.01)、0 vs 4.0%(P<0.01);术中监测组喉返神经确认时间及手术时间均比常规手术暴露组低,为5.56±1.95 min vs 15.92±2.69 min(P<0.001, t=-23.94)、113.90±9.40 min vs 132.40±21.40 min (P<0.001, t=-6.23)。 结论〓和常规手术相比,术中喉返神经监测能显著降低术后喉返神经损伤率,而且确认喉返神经和手术时间均能明显降低,缩短手术时间。

关键词: 甲状腺, 喉返神经, 损伤, 术中神经监测, 再次手术