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糖尿病神经病变对甲状腺手术期间的喉神经复发性监测的影响

Eustratios Kofopoulos-Lymperis¹, Dimitrios Papakonstantinou¹, Konstantinos Chaidas²

¹Third Department of Surgery, "Attikon" University General Hospital/National and Kapodistrian University of Athens, School of Medicine, Athens, GRC.

|November 17, 2025

概括

糖尿病 (DM) 在甲状腺切除术期间增加了复发性喉神经 (RLN) 幅度减小,表明神经性降低. 术内神经监测 (IONM) 检测到这种亚临床脆弱性,尽管短期的临床影响是最小的.

科学领域:

耳鼻喉科耳鼻喉科耳鼻喉科
内分泌学在内分泌学.
神经外科神经外科

背景情况:

回复性喉神经 (RLN) 损伤是甲状腺手术的重要并发症.
术内神经监测 (IONM) 评估RLN功能,但可能会受到糖尿病外围神经病变的影响.
糖尿病 (DM) 在甲状腺切除术期间可能会改变RLN电生理学.

研究的目的:

通过IONM来研究DM对RLN振幅和在甲状腺切除术期间的延迟的影响.
评估DM是否影响甲状腺手术期间的神经电生理反应.

主要方法:

用IONM (2020-2024) 进行甲状腺切除术的245名患者的前性分析.
根据ADA标准分类为糖尿病或非糖尿病的患者.
在切割前和切割后测量RLN振幅和延迟;通过非参数测试进行群组比较.

主要成果:

糖尿病患者 (13.9%) 年龄较大,并患有更多的并发症.
在剖析后,糖尿病患者的RLN幅度减少显著增加 (p=0.01).
RLN延迟和切割前的幅度/延迟在各组之间没有显著差异.

结论:

在甲状腺切除术期间,DM与更大的RLN振幅减少有关,这表明神经性受损.
在糖尿病患者中,IONM可以检测出这种亚临床脆弱性.
当神经完整性被保留时,电生理学变化对短期临床影响最小.

关键词:

扩展幅度扩展幅度在手术内进行神经监测 (ionm)延迟时间延迟时间经常出现的喉神经 (rln)甲状腺手术甲状腺手术 2 型糖尿病 2 型糖尿病

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The Thyroid Gland

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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