甲状腺手术中复发性喉神经麻的危险因素:一个单一中心的经验 1147 程序与间歇性手术内神经监测
Navid Tabriz1, Selma Muehlbeyer2, Dirk Weyhe1
1School VI-School of Medicine and Health Sciences, Carl von Ossietzky Universitat Oldenburg, Ammerlander Heerstrasse 114-118, 26129 Oldenburg, Germany.
Journal of personalized medicine
|July 27, 2024
概括
针对格雷夫斯病,癌症或复发性的甲状腺手术显著增加了复发性喉神经 (RLN) 麻的风险. 较长的外科手术时间也会增加这种风险,需要外科医生仔细准备.
科学领域:
- 内分泌手术 内分泌手术
- 神经外科 神经外科
- 手术风险评估手术风险评估
背景情况:
- 重复性喉神经 (RLN) 麻是甲状腺手术的已知并发症.
- 目前的实践包括手术内神经监测和神经可视化,以减轻RLN的风险.
研究的目的:
- 为了确定RLN麻的新风险因素.
- 审查RLN的确定的风险因素.
- 帮助外科医生进行甲状腺切除术的术前规划.
主要方法:
- 对1147名甲状腺切除术患者 (2016-2020年) 的回顾性分析.
- 对患者数据的描述性统计分析.
- 后勤回归模型用于识别RLN的独立风险因素.
主要成果:
- 格雷夫斯病 (OR 14.34),甲状腺癌 (OR 2.39) 和复发性 (OR 5.57) 是与结节性相比,RLN的显著危险因素.
- 加长的手术时间与较高的RLN麻风险相关 (OR 1.009).
- 在性别,BMI,切除重量,神经横向性或外科医生经验方面没有发现显著差异.
结论:
- 外科医生必须意识到在对格雷夫斯病,甲状腺癌和复发性的手术中RLN的风险增加.
- 长时间的手术时间增加了RLN的可能性.
- 在将RLN与手术方法 (甲状腺瘤切除术与全甲状腺瘤切除术) 相关联的潜在偏差需要仔细考虑.
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