术内电肌图学变化和手术程度对甲状腺切除术后食道运动的影响:一项前性队列研究
Mehmet Gunay1, Yalin Iscan1, Ismail Cem Sormaz1
1Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye.
Frontiers in endocrinology
|October 22, 2025
概括
甲状腺切除术可以影响吞功能,在手术后,食道上关节的压力下降. 在手术内神经监测 (IONM) 期间的电肌图 (EMG) 变化可能会影响这些结果.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 甲状腺切除术与潜在的术后吞困难有关.
- 术内神经监测 (IONM) 在手术期间评估神经功能.
- 高分辨率计量 (HRM) 评估食道运动性和压力.
研究的目的:
- 调查IONM期间的电肌图 (EMG) 变化与甲状腺切除术后的吞问题之间的联系.
- 评估叶切除术,全甲状腺切除术 (TTx) 和带中央淋巴结解剖 (TTx+CLND) 的TTx对吞功能的影响.
- 为了将IONM发现与手术后期HRM结果相关联.
主要方法:
- 一项前性研究涉及36名接受IONM各种甲状腺切除手术的患者.
- 在手术前和手术后6个月的吞评估使用HRM和消化障碍问卷.
- 记录和分析人口统计数据,结节大小,甲状腺体积,IONM和HRM结果.
主要成果:
- 五名患者 (14%),出现了新发作的术后失足症.
- 手术后的上食道关节静止压力 (UESRP) 显著下降 (p=0.03).
- 在患有较大的结节,较高的甲状腺体积和新发性消化不全的患者中观察到更大的UESRP减少;然而,那些有不良EMG变化的患者的减少较小.
结论:
- 在甲状腺切除术后,无论IONM检测到的神经损伤,UESRP都会下降.
- 结节大小,甲状腺体积和新发性消化不良等因素与UESRP减少相关.
- 喉肌肉中的异质神经肌肉适应可以解释对EMG变化的各种反应.
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