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术内神经监测 (IONM) 技术对甲状腺手术后患者早期康复质量的影响:一项随机对照试验

Haocong Chen¹, Zhijun Lu²

¹Department of Anesthesiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

|September 26, 2023

概括

甲状腺手术期间的手术内神经监测 (IONM) 对患者的康复产生负面影响,导致康复质量-40分数降低,术后恶心,吐和成本增加. 这些发现凸显了IONM在甲状腺切除术患者的潜在缺点.

科学领域:

麻醉学麻醉学
外科手术的结果
患者的恢复患者的恢复

背景情况:

在医学中,以患者为中心的术后康复评估至关重要.
恢复质量-40 (QoR-40) 问卷评估了手术恢复的质量.
甲状腺手术中的手术内神经监测 (IONM) 策略对患者康复的影响尚不清楚.

研究的目的:

评估IONM对甲状腺手术患者术后恢复质量的影响.
为了比较QOR-40分数,术后恶心或吐 (PONV),以及IONM和对照组之间的医疗费用.

主要方法:

80名甲状腺手术患者被随机分配到IONM组 (NEURO组) 和对照组 (CON组).
与CON组 (0.6 mg/kg) 相比,NEURO组接受的肌肉松剂初始剂量较低 (罗库0.3 mg/kg).
主要结局是手术后第1天和第3天的QoR-40分数;次要结局包括PONV发病率和医疗费用.

主要成果:

在NEURO组 (IONM) 中的患者在术后1日和3日显示全球QoR-40得分,情绪状态,身体舒适度,身体独立性和疼痛显著降低.
与CON组相比,PONV的发病率在NEURO组中较高.
在NEURO集团,医疗费用也大幅增加.

结论:

经过IONM的甲状腺切除术患者经历的术后恢复质量较差.
在甲状腺手术中使用IONM与PONV的风险更高有关.
在甲状腺手术中IONM的实施导致医疗费用增加.

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