甲状腺术中喉返神经实时监测对预防喉返神经损伤的Meta分析

李可亮; 李进让

doi:10.13201/j.issn.1001-1781.2014.24.010

甲状腺术中喉返神经实时监测对预防喉返神经损伤的Meta分析

李可亮^1,2,
李进让^1, ,

- 海军总医院全军耳鼻咽喉头颈外科中心(北京, 100048)

详细信息

通讯作者: 李进让,E-mail:entljr@sina.com

中图分类号: R653

收稿日期: 2014-07-29

Meta analysis of the real-time nerve monitoring in prevention of recurrent laryngeal nerve injury during thyroid surgery

LI Keliang^1,2,
LI Jinrang^1, ,

- Department of Otolaryngology Head and Neck Surgery, Navy General Hospital, Beijing, 100048, China

More Information

Corresponding author: LI Jinrang, E-mail: entljr@sina.com

Received Date: 29 July 2014

摘要

摘要: 目的:通过Meta分析的方法,比较甲状腺手术中喉返神经实时监测与常规暴露两种方式在预防喉返神经损伤与喉返神经识别率方面的优缺点。方法:依照既定的纳入和排除标准,通过计算机对中国生物医学文献数据库(CBM)、Pubmed数据库、万方数据库、中国知网(CNKI)等中英文数据库的相关文献进行检索,并结合文献追溯、网上查询的方法,收集所有相关的随机对照研究或病例对照研究。以客观有效率合并OR值为效应指标,对各资料进行异质性检验,以确定采用固定或随机效应模型进行合并分析。结果:共纳入文献6篇,涉及12 646例喉返神经,Meta分析结果显示:喉返神经实时监测组的喉返神经暂时性损伤发生率低于常规暴露组(OR=0.60,95% CI=0.49~0.73,P<0.01);实时监测组与常规暴露组的喉返神经永久性损伤发生率差异无统计学意义(OR=0.90,95% CI=0.57~1.40, P>0.05);实时监测组与常规暴露组的喉返神经识别率差异无统计学意义(OR=9.79,95% CI=0.17~548.64, P>0.05)。结论:甲状腺术中喉返神经实时监测在降低喉返神经暂时性损伤发生率方面优于常规暴露组,但两组间喉返神经永久性损伤发生率和喉返神经识别率没有明显差异。甲状腺术中喉返神经监测对预防喉返神经损伤有一定作用。
- 喉返神经 /
- 实时监测 /
- 甲状腺手术 /
- Meta分析
Abstract: Objective:To compare the advantages and disadvantages of real time recurrent laryngeal nerve (RLN) monitoring and conventional exposure during thyroid operation by Meta analysis. Method:The published articles of randomized controlled clinical trials were searched in data bases to compare the therapeutic outcomes of using real-time RLN monitoring and conventional exposure in thyroid surgery.The quality of the searched original studies was assessed and the outcomes which are in line with the requirements were analyzed.Result:Six articles met the inclusion criteria,which contained 12646 RLN in total.There were 5535 cases in the RLN monitoring group and 7111 cases in the conventional exposure group.The results of Meta analysis showed that:the transient injury rate of the RLN in the monitoring group (OR=0.60,95% CI=0.49-0.73, P<0.01) was lower than that in the conventional exposure group, but the permanent injury rate of the RLN in two groups had no statistical difference (OR=0.90,95% CI=0.57-1.40, P>0.05). The RLN identification rate also had no statistical difference between the two groups (OR=9.79,95% CI=0.17-548.64, P>0.05).Conclusion:The transient injury rate of the RLN is lower in the monitoring group than that in conventional exposure group, but the permanent injury rate and the RLN identification rate had no statistical difference between the two groups. The intraoperative nerve monitoring was useful in the prevention of the RLN injury in thyroid surgery.
- recurrent laryngeal nerve /
- real-time monitoring /
- thyroid surgery /
- Meta analysis

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参考文献(14)

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