甲状腺切除术后对良性和恶性病变的复发性喉神经冲击发生率的比较
Sahel W Haddadin1, Ahmad M Mahasna1, Ibrahim Ak Abumekhleb1
1Department of General Surgery, JRMS, KHMC, Amman, Jordan.
Medical archives (Sarajevo, Bosnia and Herzegovina)
|September 13, 2023
概括
甲状腺癌,全甲状腺切除术和男性性别显著增加了甲状腺手术期间复发性喉神经损伤 (RLNI) 的风险. 了解这些因素对于预防手术后声带功能障碍至关重要.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术瘤学手术瘤学
- 内分泌学 在内分泌学.
背景情况:
- 喉神经复发性损伤 (RLNI) 是甲状腺手术的重大并发症,可能导致声带或.
- RLNI的发病率从1.5%到20%不等,单方面侮辱导致声和双边侮辱导致危及生命的呼吸道阻塞.
- 在重复手术甲状腺手术,格雷夫斯病和甲状腺癌手术中观察到RLNI的风险更高.
研究的目的:
- 在接受甲状腺手术的患者中,调查和确定与复发性喉神经损伤 (RLNI) 相关的特定风险因素.
- 在涉及良性与恶性甲状腺病变的病例中区分RLNI的危险因素.
主要方法:
- 在2019年10月至2022年10月期间接受甲状腺手术的255名患者 (21-59岁) 的回顾性分析.
- 进行了手术前和后间接的喉腔镜检查,以评估声带功能.
- 使用统计分析,包括千二测试,来评估潜在风险因素的意义 (P < 0.05).
主要成果:
- 在甲状腺切除术后的9.8% (25/255) 患者中发生了重复性喉神经损伤 (RLNI).
- 整体或近整体甲状腺切除术 (25.9%) 和恶性病变 (17.1%) 与RLNI的发病率相比,甲状腺切除术和良性病变的发病率相对较高.
- 与女性患者 (8.8%) 相比,男性患者的RLNI风险较高 (12.2%).
结论:
- 甲状腺癌,全甲状腺切除术和男性性别被确定为重复性喉神经损伤 (RLNI) 的重要危险因素.
- 这些发现强调了谨慎的手术技术和患者选择在尽量减少RLNI风险方面的重要性.
- 进一步的研究可能将重点放在制定减轻这些已确定的风险的策略上.
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