术中神经监测技术在分化型甲状腺癌再次手术中的应用

目的 探讨术中神经监测(IONM)技术在分化型甲状腺癌再次手术中的应用价值。方法 分析济南军区总医院甲状腺乳腺外科47例分化型甲状腺癌再手术患者的临床病理资料，并在再次手术中应用IONM技术。结果 再次手术后病理结果显示，再次手术前甲状腺癌残留率为45.45%，颈淋巴结转移率为82.98%。再次手术中无新的迷走神经和喉返神经损伤发生。结论 初次手术术式选择不当是造成分化型甲状腺癌患者再次手术的主要原因，IONM技术可预防和减少分化型甲状腺癌再次手术中喉返神经损伤，应作为这类手术中的常规应用技术。

Intra-operative nerve monitoring in re-operation for differentiated thyroid carcinoma

Objective To investigate the value of intra-operative nerve monitoring(IONM) in re-operation for differentiated thyroid carcinoma. Method Forty-seven patients enrolled in our department were performed IONM in re-operation. Results Post-operative pathology showed that 45.45% of the lesions were cancer and 82.98% of the lymph nodes were transferred. No vagus nerve and recurrent laryngeal nerve injures happened in the operations. Conclusion First inappropriate operative procedure is the main reason resulting in re-operation. IONM can be used to prevent and reduce the recurrent laryngeal nerve injure.