甲状腺手术后喉神经复发损伤的危险因素:系统性审查和元分析
Xiang Yang1, Wuzhou Ouyang2, Peng Ma1
1Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital, Nanchong, China.
Frontiers in surgery
|January 23, 2026
概括
年龄较大,女性性别,广泛的甲状腺切除术,淋巴结剖析,再手术,后鼻,以及缺乏神经监测是甲状腺手术后 recurrent laryngeal神经损伤的关键风险因素.
科学领域:
- 手术并发症 手术并发症
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 内分泌手术 内分泌手术
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,可能导致声和食障碍.
- 现有的关于RLNI风险因素的研究不一致,需要全面综合证据.
研究的目的:
- 系统地审查和分析现有文献,以确定和量化与甲状腺切除术后RLNI相关的风险因素.
- 在甲状腺手术期间增加神经损伤的可能性的因素的综合理解.
主要方法:
- 在2025年10月之前,对主要数据库 (PubMed,Embase,Web of Science,Cochrane Library) 进行了系统的搜索.
- 包括观察性研究和RCT,由两个独立研究人员进行数据提取和质量评估.
- 使用Stata 15进行了元分析,以计算聚合赔率比率 (OR) 和95%置信区间 (CI).
主要成果:
- 对20项研究 (N=108,343) 的分析确定了年龄较大 (OR=1.45),女性性别 (OR=1.15),扩展甲状腺切除术 (OR=1.65) 和淋巴结解剖 (OR=2.28) 作为显著的危险因素.
- 再手术 (OR=2.16),后侧 (OR=2.85) 和缺乏手术内神经监测 (OR=1.64) 也与增加RLNI风险密切相关.
结论:
- 年龄较大,女性性别,更广泛的手术,淋巴结剖析,重新手术,背侧,以及缺乏神经监测是RLNI的独立风险因素.
- 这些发现可以为手术决策和降低风险的策略提供信息,以减少甲状腺手术期间的神经损伤.
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