甲状腺术中应用地塞米松局部给药对喉返神经功能恢复的影响

摘要
图/表
参考文献(17)
相关文章 (15)

全文: PDF (0 KB) HTML (34 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨甲状腺术中应用地塞米松局部给药对喉返神经（RLN）功能恢复的影响。方法选择2019年8月—2020年9月景德镇市第三人民医院收治的60 例甲状腺占位性疾病患者，以随机数字表法分为高剂量组、低剂量组与对照组，各20 例。术中对照组予以生理盐水5 mL 局部湿敷，高剂量组予以5 mg 地塞米松+5 mL 生理盐水局部湿敷，低剂量组予以3 mg 地塞米松+5 mL 生理盐水局部湿敷，比较术后三组声带运动恢复情况及声音质量。结果三组术后1 个月时声带运动恢复率比较，差异无统计学意义（P＞0.05）；高剂量组、低剂量组术后3 个月时声带运动恢复率高于对照组，差异有统计学意义（P＜0.05）；高剂量组、低剂量组术后3 个月时声带运动恢复率高于术后1 个月时，差异有统计学意义（P＜0.05），对照组声带术后3 个月时运动恢复率高于术后1 个月时，但差异无统计学意义（P＞0.05）；高剂量组、低剂量组术后3 个月时声带运动恢复率比较，差异无统计学意义（P＞0.05）；高剂量组、低剂量组术后3 个月时声音质量改善率高于对照组，差异有统计学意义（P＜0.05）；高剂量组、低剂量组术后3 个月时声音质量总改善率比较，差异无统计学意义（P＞0.05）。结论对甲状腺手术患者术中采用地塞米松局部给药，可促进RLN 功能恢复，改善声音质量。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：甲状腺手术, 地塞米松, 喉返神经功能, 局部给药

Abstract：Objective To investigate the effect of local administration of Dexamethasone in thyroid surgery on the functional recovery of recurrent laryngeal nerve (RLN).Methods Sixty patients with thyroid occupying disease who were admitted to Jingdezhen Third People′s Hospital from August 2019 to September 2020 were selected and divided into the high dose group, the low dose group and the control group by the random number table method, with 20 cases in each group.During the surgery, the control group was given local wet compress of 5 mL normal saline;the high dose group was given local wet compress of 5 mg dexamethasone + 5 mL normal saline;the low dose group was given local wet compress of 3 mg Dexamethasone+ 5 mL normal saline.The recovery of vocal cord motion and sound quality of the three groups were compared after surgery.Results No significant differences were observed in the recovery rates of vocal cord motion among the three groups at 1 month after surgery (P＞0.05).The respective recovery rate of vocal cord motion in the high dose group and low dose group was higher than that in the control group at 3 months after surgery,and the differences were statistically significant (P＜0.05).The respective recovery rate of vocal cord motion in the high dose group and the low dose group at 3 months after surgery was higher than that at 1 month after surgery, with statistically significant differences (P＜0.05).In the control group,the recovery rate of vocal cord motion at 3 months after surgery was higher than that at 1 month after surgery, but the difference was not statistically significant (P＞0.05).No significant difference was observed in the recovery rate of vocal cord motion at 3 months after surgery between the high dose group and the low dose group (P＞0.05).The respective improvement rate of sound quality in the high dose group and the low dose group was higher than that in the control group at 3 months after surgery,with statistically significant differences (P＜0.05).No significant difference was observed in the total improvement rate of sound quality between the high dose group and the low dose group at 3 months after surgery (P＞0.05).Conclusion Intraoperative local administration of Dexamethasone in patients undergoing thyroid surgery can promote the recovery of RLN function and improve the sound quality.

Key words： Thyroid surgery Dexamethasone Recurrent laryngeal nerve function Local administration

收稿日期: 2021-02-01

基金资助:江西省景德镇市科技计划项目（20192SFZC009）

作者简介: 邓汇典（1984-），男，湖南郴州人，研究方向：普外科

引用本文:

邓汇典；黄金龙；王娟. 甲状腺术中应用地塞米松局部给药对喉返神经功能恢复的影响[J]. 中国当代医药, 2021, 28(20): 144-146转150.
DENG Hui-dian HUANG Jin-long WANG Juan. Effect of local administration of Dexamethasone in thyroid surgery on functional recovery of recurrent laryngeal nerve. 中国当代医药, 2021, 28(20): 144-146转150.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I20/144

[1]	孙辉，刘晓莉.甲状腺手术中喉返神经损伤及恢复[J].中华外科杂志，2017，55（11）：875-876.
[2]	刘溦薇，邓先兆，樊友本，等.甲状腺术中喉返神经的损伤和预防[J].国际外科学杂志，2015，42（2）：122-126.
[3]	石岚，程波，屈新才，等.甲状腺手术中喉返神经损伤原因及预防[J].中国实用外科杂志，2007，27（11）：897-899.
[4]	马志跃，李彬，冯勇，等.显露喉返神经甲状腺手术对预防喉返神经损伤的影响[J].实用医院临床杂志，2016，13（3）：81-82.
[5]	李运，赵楠，孙树俊，等.甲强龙与地塞米松复合托烷司琼对甲状腺术后恶心呕吐高危患者的预防效果比较[J].中国医师杂志，2017，19（2）：224-231.
[6]	孙太冉，李秀芬，鲁蓓，等.传统甲状腺切除术与小切口甲状腺切除术治疗甲状腺结节的对比研究[J].山西医药杂志，2017，46（2）：173-175.
[7]	何文海．精细化被膜解剖技术在甲状腺手术中的应用效果[J]．广西医学，2017，39（2）：261-262，271．
[8]	肖海.甲状腺癌手术导致喉返神经损伤的临床分析[J].河北医药，2019，41（4）：595-597.
[9]	郑力．改良小切口手术治疗老年甲状腺瘤疾病的临床观察[J]．老年医学与保健，2017，23（2）：125-127．
[10]	孙辉，刘晓莉．甲状腺手术中喉返神经损伤及恢复[J]．中华外科杂志，2017，55（11）：875-876．
[11]	白玉，徐文，胡蓉，等．喉返神经损伤后神经肌肉变化及再生特点研究[J]．临床耳鼻咽喉头颈外科杂志，2017，31（12）：41-45．
[12]	余青原，李永桂，阿曼古丽·苏力唐，等．地塞米松联合甲状腺素钠治疗对自身免疫性甲状腺炎患者相关血清细胞因子、Th1/Th2 相关细胞因子的影响[J]．疑难病杂志，2018，17（11）：1233-1237．
[13]	Exarchos ST，Lachanas VA，Tsiouvaka S，et al．The impact of perioperative Dexamethasone on swallowing impairment score after thyroidectomy．A retrospective study of 118 total thyroidectomies[J]．Clin Otolaryngol，2016，41（5）：615-618．
[14]	张慧文，周全红．预防性小剂量地塞米松对甲状腺切除术后的影响[J]．医学综述，2016，22（6）：1152-1155．
[15]	时伟锋，邹汉青．甲状腺手术中应用类固醇激素保护喉返神经功能的研究[J]．中国现代医学杂志，2015，25（7）：61-63．
[16]	张智，邵淑芹，黄志伟．地塞米松对甲状腺手术中喉返神经的保护作用[J]．中国现代普通外科进展，2016，19（4）：258．
[17]	陈婧，胡蕴，毛晓明．N-乙酰半胱氨酸，还原型谷胱甘肽及地塞米松对人甲状腺细胞氧化应激的影响[J]．中华内分泌代谢杂志，2015，31（1）：71-74．