| Objective In this study,we compared the effect of the Secondary surgical lymph node dissection in the treatment of thyroid cancer with and without recurrent laryngeal nerve monitor.This paper mainly studies the use of recurrent laryngeal nerve monitoring in the Secondary operation of thyroid cancer,and analyzes the distinguish of recurrent laryngeal nerve,The time of operation and the amount of bleeding during operation,the drainage volume and the number of lymph nodes were observed in the left and right thyroid cancer.The differences of the separation time and injury rate of the left and right recurrent laryngeal nerve were compared with recurrent laryngeal nerve monitor in order to provide a reference for clinical research,It also discusses the significance of the application of this technique in lymph node dissection,which will promote the further application and surgical applicationMethods In this study,84 cases of patients receiving secondary surgery for unilateral thyroid cancer in our hospital since January 2015 to December 2016 were selected for this study,left 31 cases,right 53 cases.These patients were divided into two groups,which meant 42 cases of patients in one group with recurrent laryngeal nerve detector(IONM group)and 42 cases of patients in the other group without recurrent laryngeal nerve detector(none IONM group).Information about operative time,blood loss and vocal cords damage situation were collected for the total value and the individual value of the left and right recurrent laryngeal nerve during the surgery and after the surgery.The daily volume of drainage in three days after surgery and the vocal movement one day and one week after the surgery were detected.Result In the case of time spent in the secondary surgery of left and right thyroid cancer,the IONM group were obviously less than the none IONM group(57.0 ± 5.2 and61.2±5.7minutes,P<0.05;59.6± 6.8 and 65.4±5.9,P<0.05).There was no obvious difference in the average blood loss between the two(10.6± 3.4?12.7 ± 4.2ml,P>0.05;11.3.± 4.5,12.7± 5.6,P>0.05).As for the volume of drainage of left and right sides in 1,2,3 days after surgery,the IONM group was obviously less than the none IONM group(P<0.05),and vocal moment abnormality of the IONM group one day after surgery was obviously less than that of the none IONM group(1 case,2.3%;5 cases,11.9%,P<0.05).vocal moment abnormality of the IONM group one week after surgery was obviously less than that of the none IONM group(0case,0%;4 cases,9.5%,P<0.05).In IONM group,the isolation time needed by left recurrent laryngeal nerve was obviously less than that needed by the right one(10.6± 2.6min?16.5 ± 3.2,P<0.05),but the damage of the twowas not significantly different(0% and 4.5%,P>0.05).Conclusion The results of this study indicate that the use of recurrent laryngeal nerve in the detection of secondary thyroid cancer lymph node clearance surgery has certain advantages,Can effectively reduce the operation time,flow rate,while reducing the incidence of recurrent laryngeal nerve injury,postoperative recovery also has a positive effect,At the same time,it can protect the recurrent laryngeal nerve,and can effectively improve the quality of life after surgical treatment.However,it has no effect on the amount of bleeding and the number of lymph nodes removed.In group IONM,the Separation timeof the left recurrent laryngeal nerve was shorter than that of the right recurrent laryngeal nerve,However,there was no significant difference between the two groups Injury at rate of recurrent laryngeal nerve.This test will increase part of the cost of treatment,so in the treatment of thyroid cancer,can be considered appropriate to choose the application of recurrent laryngeal nerve detector... |
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