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

Application of continuous intraoperative neuromonitoring in recurrent laryngeal nerve protection during thyroidectomy

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。

Abstract: 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.