介入超声治疗甲状腺切除术后声带功能障碍的初步探讨。

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology Pub Date : 2024-12-27 DOI:10.1016/j.ultrasmedbio.2024.11.021

Zhihao Jiang , Yifan Zhu , Bin Li , Zhen Shan , Shasha Huang , Jie Deng , Zhu Wang

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引用次数: 0

摘要

目的：探讨超声介入治疗甲状腺切除术后喉返神经损伤所致声音嘶哑的疗效。材料与方法：回顾性分析我院2023年8月1日至2024年1月31日期间接受介入超声治疗（超声引导下注射地普散与生理盐水混合物）治疗甲状腺术后声音嘶哑的21例患者（地普散组）的临床资料，并随机选取同期未接受任何治疗的甲状腺术后声音嘶哑患者21例作为对照组。计算地普洛散组的平均声带活动改善时间，并与先前研究中未治疗的患者进行比较。分别于甲状腺切除术后1、2和3个月评估声带活动改善率，并评估治疗前后语音障碍指数（VHI）和主观听力感知量表（GRBAS）评分的变化。并比较甲状腺切除术后2周内治疗（及时干预组，TI组）与术后2周治疗（延迟干预组，DI组）的疗效，探讨治疗时间对预后的影响。结果：地普洛散组甲状腺切除术后2周内治疗的声带活动改善时间平均为44.6±4.7 d，甲状腺切除术后2周治疗的声带活动改善时间平均为17.7±1.5 d，均明显短于文献报道的6个月~ 1个月。在甲状腺切除术后1、2、3个月，双普洛桑组的改善率显著高于对照组（0.0%比28.6%，23.8%比81.0%，33.3%比90.5%,p < 0.05）。治疗后VHI评分（72.6±21.2比12.6±24.7,p < 0.001）和GRBAS评分（12.0比0.0,p < 0.001）均显著改善。与DI组相比，TI组的语音恢复速度更快（19.8±5.8 d比14.0±2.6 d, p < 0.05）。未观察到治疗相关的不良反应。结论：超声介入治疗甲状腺切除术后嗓音嘶哑是一种安全有效的治疗方法，可有效改善声带活动能力，促进嗓音恢复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Effect of Interventional Ultrasound in the Treatment of Postthyroidectomy Vocal Cord Dysfunction: A Preliminary Exploratory Study

Purpose

To explore the efficacy of interventional ultrasound treatment for hoarseness caused by nondisconnected recurrent laryngeal nerve injury after thyroidectomy.

Materials and methods

In this retrospective study, we analysed the clinical data of 21 patients who underwent interventional ultrasound therapy (ultrasound-guided injection of a Diprospan and saline mixture) for postthyroidectomy hoarseness at our hospital between August 1, 2023, and January 31, 2024 (the Diprospan group) and randomly selected 21 patients who did not receive any treatment for postthyroidectomy hoarseness during the same period as the control group. The average vocal cord activity improvement time for the Diprospan group was calculated and compared with that of untreated patients from previous studies. Vocal cord activity improvement rates were assessed at 1, 2, and 3 mo after thyroidectomy, and changes in the voice handicap index (VHI) and the subjective listening perception scale (GRBAS) scores before and after treatment were evaluated. Additionally, the efficacy was compared between patients treated within 2 wk (timely intervention group, TI group) and those treated 2 wk after thyroidectomy (delayed intervention group, DI group) to explore the impact of treatment timing on outcomes.

Results

In the Diprospan group, the average vocal cord activity improvement time was 44.6 ± 4.7 d for those treated within 2 wk after thyroidectomy and 17.7 ± 1.5 d for those treated 2 wk after thyroidectomy, both of which were significantly shorter than the 6 mo to 1 y reported in the literature. The improvement rates at 1, 2, and 3 mo after thyroidectomy were significantly greater in the Diprospan group than in the control group (0.0% vs. 28.6%, 23.8% vs. 81.0%, 33.3% vs. 90.5%, p < 0.05). The VHI score (72.6 ± 21.2 vs. 12.6 ± 24.7, p < 0.001) and GRBAS score (12.0 vs. 0.0, p < 0.001) significantly improved after treatment. Compared with the DI group, the TI group also showed faster voice recovery (19.8 ± 5.8 d vs. 14.0 ± 2.6 d, p < 0.05). No treatment-related adverse reactions were observed.

Conclusion

Interventional ultrasound is a safe and effective treatment for hoarseness after thyroidectomy, as it effectively improves vocal cord mobility and accelerates voice recovery.

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来源期刊

Ultrasound in Medicine and Biology 医学-核医学

CiteScore

6.20

自引率

6.90%

发文量

325

审稿时长

70 days

期刊介绍： Ultrasound in Medicine and Biology is the official journal of the World Federation for Ultrasound in Medicine and Biology. The journal publishes original contributions that demonstrate a novel application of an existing ultrasound technology in clinical diagnostic, interventional and therapeutic applications, new and improved clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and the interactions between ultrasound and biological systems, including bioeffects. Papers that simply utilize standard diagnostic ultrasound as a measuring tool will be considered out of scope. Extended critical reviews of subjects of contemporary interest in the field are also published, in addition to occasional editorial articles, clinical and technical notes, book reviews, letters to the editor and a calendar of forthcoming meetings. It is the aim of the journal fully to meet the information and publication requirements of the clinicians, scientists, engineers and other professionals who constitute the biomedical ultrasonic community.