甲状腺及甲状旁腺术中神经监测的研究现状

Application of intraoperative neuromonitoring technology during thyroid and parathyroid surgery

摘要:

喉返神经及喉上神经的保护一直是甲状腺及甲状旁腺手术中的重点和难点，传统方式通常为视觉暴露或区域保护，但是颈部手术空间狭小，上述方法具有一定局限性。现阶段多借助于神经监测，该技术的使用有助于降低手术难度，缩短手术时间。甲状腺术中神经监测是神经电生理在临床中的良好应用，有助于更好地保护喉返神经及喉上神经。本文通过结合近年最新研究进展，从神经监测的原理、具体分类、腔镜手术应用及不良因素的规避等方面进行综述与探讨。

Abstract:

It has been important but difficult to protect the recurrent laryngeal and superior laryngeal nerve during thyroid and parathyroid surgery. Traditional measures as visual exposure and area protection adopted by surgeons were limited in application because of narrow operating space. As a good application of neuroelectrophysiology in clinic, the intraoperative neuromonitoring helps to reduce the operation difficulty and shorten the operation time as well as preferably protect the recurrent laryngeal and superior laryngeal nerve during thyroid and parathyroid surgery. Combined with the latest research progresses, this article reviews the principles, the specific classification, the application in laproscopic surgery and the circumvention of unfavorable factors of neuromonitoring.