甲状腺腺叶切除术中喉返神经入喉处解剖暴露的临床效果
摘要
探讨甲状腺腺叶切除术中喉返神经入喉处解剖暴露的临床效果。选取60例行甲状腺腺叶切除术的患者,随机均分为两组,一组予以喉返神经入喉处解剖暴露(实验组),另一组予以甲状腺下动脉下方解剖暴露(对照组),术后观察分析两组患者的临床效果。两组患者喉返神经损伤的发生率相比较差异无统计学意义(P>0.05)。但在手术时间、术中失血量方面,实验组更具优势(P<0.01)。对照组患者术后VAS评分为(4.3±2.1)分,明显高于实验组的(2.1±1.0)分,差异有统计学意义(P<0.05)。实验组术后满意度为96.67%,明显高于对照组的83.33%(P<0.05)。喉返神经入喉处解剖暴露,对于甲状腺腺叶切除术患者而言,其喉返神经损伤率低、手术时间短、术中失血量少,是一种较为实用的医疗方案,值得推广。
引文
[1]孙瑜宁,张恩东,孙彦.甲状腺腺叶切除术中两种不同解剖方法暴露喉返神经的临床观察[J].青岛医药卫生,2011,43(1):19-20.
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[7]陈海亮,赵兴文,王胜,等.甲状腺肿瘤腺叶切除术83例临床分析[J].中国现代普通外科进展,2012,15(2):152-153.
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[12]Tabit CE,Chung WB,Hamburg NM,et al.Endothelial dysfunction in diabetes mellitus:molecular mechanisms and clinical implications[J].Rev Endocr Metab Disord,2010,11(1):61-74.
[13]Nicolls MR,Haskins K,Flores SC.OXidant stress,immune dysregulation,and vascular function in type I diabetes[J].Antio Xid Redo X Signal,2012,9(7):879-889.
[14]Gokce N,Vita JA,Mc Donnell M,et al.Effect of medical and surgical weight loss on endothelial vasomotor function in obese patients[J].Am J Cardiol,2011,95(2):266-268.
[15]Lteif AA,Han K,Mather KJ.Obesity,insulin resistance,and the metabolic syndrome:determinants of endothelial dysfunction in whites and black[J].Circulation,2013,112(1):32-38.
[2]董频,姜彦,谢晋,等.甲状腺手术中喉返神经的保护对策[C].全国第四届甲状腺肿瘤学术大会论文集,2010:175-179.
[3]张振东.喉返神经喉外分支的临床意义(附13例报告)[J].外科理论与实践,2002,7(4):295-297.
[4]侯远发,朱江,侯东生,等.胸骨上内镜下甲状腺切除术临床应用解剖学[J].中国临床解剖学杂志,2007,25(5):528-530.
[5]杨心青,叶青,沈帆,等.甲状腺手术中喉返神经解剖的探讨(附396例分析)[J].中国医药导报,2013,30(2):22-23.
[6]吴春光.腺叶切除术治疗急性化脓性甲状腺炎临床观察[J].中国现代普通外科进展,2015,18(9):712-713.
[7]陈海亮,赵兴文,王胜,等.甲状腺肿瘤腺叶切除术83例临床分析[J].中国现代普通外科进展,2012,15(2):152-153.
[8]Foley RN,Parfrey PS,Sarnak MJ.Epidemio logy of cardiovascular disease in chronic renal disease[J].J Am Soc Nephrol,2013,9(12Suppl):S16-23.
[9]Malyszko J.Mechanism of endothelial dysfunction in chronic kidney disease[J].Clin Chim Acta,2010,411(19/20):1412-1420.
[10]Izumi S,Muano T,Mori A,et al.Common carotid artery stiffness,cardiovascular function and lipid meta bolism after menopause[J].Life Sci,2012,78(15):1696-1701.
[11]Izzard AS,Rizzoni D,Agabiti-Rosei E,et al.Small artery structure and hypertension:adaptive changes and target organ damage[J].JHypertens,2011,23(2):247-250.
[12]Tabit CE,Chung WB,Hamburg NM,et al.Endothelial dysfunction in diabetes mellitus:molecular mechanisms and clinical implications[J].Rev Endocr Metab Disord,2010,11(1):61-74.
[13]Nicolls MR,Haskins K,Flores SC.OXidant stress,immune dysregulation,and vascular function in type I diabetes[J].Antio Xid Redo X Signal,2012,9(7):879-889.
[14]Gokce N,Vita JA,Mc Donnell M,et al.Effect of medical and surgical weight loss on endothelial vasomotor function in obese patients[J].Am J Cardiol,2011,95(2):266-268.
[15]Lteif AA,Han K,Mather KJ.Obesity,insulin resistance,and the metabolic syndrome:determinants of endothelial dysfunction in whites and black[J].Circulation,2013,112(1):32-38.