在甲状腺手术期间持续的手术内迷走神经神经监测的安全性
Timothy Mathieson1, Wedali Jimaja1, Frédéric Triponez1
1Department of Thoracic and Endocrine Surgery and Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland.
BJS open
|June 8, 2023
概括
持续的手术内神经监测 (cIONM) 可能会影响迷走神经,但其影响是轻微的,没有临床意义. 这项研究证实cIONM是甲状腺手术的安全工具.
科学领域:
- 神经外科 神经外科
- 电子生理学 电子生理学
- 内分泌手术 内分泌手术
背景情况:
- 持续的手术内神经监测 (cIONM) 有助于预测手术期间的喉神经复发损伤.
- cIONM的安全性,特别是它对迷走神经的影响,仍然是争论的主题.
- 这项研究研究了CIONM对迷走神经的电生理效应.
研究的目的:
- 评估cIONM电极放置在迷走神经复发性喉神经轴上的电生理影响.
- 为了确定CIONM是否会对迷走神经造成伤害的风险.
主要方法:
- 一项前性研究,测量迷走神经电动图波幅在刺激电极的近距离和远距离.
- 测量是在三个手术时间点进行的:解剖期间,电极应用之前和摘除后.
- 分析了108名接受内分泌部手术的患者的169根迷走神经.
主要成果:
- 电极应用导致近距离振幅显著下降 (-10.94μV,P < 0.005).
- 在移除电极之前观察到进一步的下降 (-18.58μV,P < 0.005).
- 七个神经 (约4%) 经历了幅度损失超过了基线的20%.
结论:
- cIONM电极放置对迷走神经循环喉神经轴有轻微的电生理影响.
- 观察到的振幅变化是可以忽略不计的,并且与临床相关的结果无关.
- 尽管存在潜在的轻微副作用,但cIONM在选择的甲状腺手术中是一种安全的辅助剂.
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