持续术中神经监测技术在甲状腺手术喉返神经保护中的应用现状

摘要

喉返神经损伤是甲状腺手术中的严重并发症,可导致患者声音嘶哑或失声,甚至死亡.术中神经监测(intraoperative neuro monitoring,IONM)应用电生理技术监测手术中喉返神经的功能完整性,从而降低神经损伤的发生率.持续术中神经监测技术(continuous intraoperative neuro monitoring,C-IONM)能够克服既往IONM间断监测的弊端,通过刺激迷走神经而持续地监测术中喉返神经的功能变化,为喉返神经提供更有效的保护.本文就C-IONM技术在甲状腺手术应用中的原理、操作步骤、优势及安全性等方面进行综述.%Recurrent laryngeal nerve (RLN) injury is a serious complication of thyroid surgery,which may cause hoarseness of voice or aphonia in patients,or even death.Intraoperative neuromonitoring (IONM) is a technology for identifying the integrity of nerves during operation by electrophysiological means,so as to reduce the chance of RLN injury.Continuous intraoperative neuromonitoring (C-IONM) can provide real-time monitoring of the vagus nerve (VN) in order to prevent RLN damages,overcoming the disadvantages of IONM.This paper reviews the application of C-IONM technology in thyroid surgery,including its technical mechanism,procedures,advantages,safety and so on.