作　　者： (周忠涵）; (陈雪红）; (王士东）; (李雪鹏）;

机构地区： 青岛大学,山东青岛266071

出　　处： 《青岛大学医学院学报》 2017年第3期264-268,共5页

摘　　要： 目的比较国内甲状腺手术术中神经实时监测(IONM)与常规暴露预防喉返神经(RLN)损伤的优缺点。方法检索万方、CNKI、CBM、Pubmed、Embase等数据库,收集国内关于甲状腺手术中RLN的IONM和常规暴露两种手术方式效果的随机对照试验、病例对照研究以及队列研究,应用Stata 13.0软件对数据进行Meta分析,比较结局指标的差异。结果共纳入12篇文献,病人4 820例,神经5 134条,结果显示IONM组RLN暂时性损伤率低于常规暴露组(OR=0.40,95%CI=0.26~0.62),IONM组永久性损伤率与常规暴露组比较差异无统计学意义(OR=0.42,95%CI=0.16~1.13)。结论甲状腺手术IONM可减少RLN暂时性损伤,合理应用RLN术中监测具有重要意义。 Objective To investigate the advantages and disadvantages of intraoperative neuromonitoring（IONM）versus conventional exposure of recurrent laryngeal nerve（RLN）in preventing RLN injury in thyroid surgery. Methods Wanfang Data,CNKI,CBM,PubMed,and Embase were searched for randomized controlled trials,case-control studies,and cohort studies on the effect of IONM versus conventional exposure of RLN in thyroid surgery.Stata 13.0software was used to perform the Meta-analysis and compare the outcomes. Results A total of 12 articles with 4 820 patients and 5 134 nerves were included.The Meta-analysis showed that the IONM group had a lower rate of temporary injury than the conventional exposure group（OR=0.40,95% CI=0.26-0.62）,and there was no significant difference in the rate of permanent injury rate between the two groups（OR=0.42,95%CI=0.16-1.13）. Conclusion IONM in thyroid surgery can reduce temporary RLN injury,and rational application of IONM of RLN in thyroid surgery has great significance.

关 键 词： 甲状腺切除术 喉返神经 术中神经监测 分析