The Clinical Value Of Intraoperative Nerve Monitoring Technique In Thyroid Surgery

Objective To explore the application value of intraoperative nerve monitoring(IONM)in thyroid surgery.Methods The clinical data of 445 patients underwent an operation for thyroid in Department of Gastrointestinal Gland Surgery,the First Affiliated Hospital of Guangxi Medical University,from August 2015 to October 2016 were collected.Among them,213 patients were divided in neurological monitoring group and 232 patients were divided in conventional exposure group.Patients in neurological monitoring group were protected recurrent laryngeal nerve with intraoperative nerve monitoring,patients in conventional exposure group were were protected recurrent laryngeal nerve without intraoperative nerve monitoring.Compare the rate of temporary RLN injury,the rate of permanent RLN injury,operation time,intraoperative blood loss,postoperative drainage,postoperative extubation time,the average hospital stay and hospital charges between two groups.Results The rate of temporary RLN injury in the neurological monitoring group was lower than that in the conventional exposure group,and the temporary RLN injury rate was 1.40% vs.5.28%(P < 0.05),The rate ofpermanent RLN injury in the neurological monitoring group was also lower than that in the conventional exposure group,and the permanent RLN injury rate was0.28% vs.1.06%(P > 0.05).The operation time,intraoperative blood loss,postoperative drainage,postoperative extubation time and the average hospital stay were significantly lower in the neurological monitoring group than in the conventional group.Among them,the time of operation in both groups were163.71±79.26 min vs.192.62±100.60 min(P <0.05);the intraoperative blood loss in both groups were 36.77± 29.85 ml vs.57.41 ± 29.95 ml(P <0.05);the postoperative drainage in both groups were 59.81±53.49 ml vs.89.80±70.39ml(P <0.05);the time of postoperative extubation in both groups were 2.16±1.31 d vs.3.16±1.18 d(P<0.05);the average hospital stay in both groups were7.60 d±2.24 d vs.8.22±2.12 d(P<0.05).Hospital charge in the neurological monitoring group was higher,the median hospital charges in both groups were2.08±0.33 million vs.1.70±0.34million(P<0.05).Conclusions Compared with the conventional exposure,application of IONM in thyroid surgery can help to operation more quickly,protect RLN more effectively,reduce the rate of RLN injury,reduce the intraoperative blood,loss the amount of postoperative drainage,reduce the average hospital stay and the time of drainage tube,but the hospital charge was higher.This technology has a greater value in thyroid surgery.