Luo Yongtao, Cheng Hui
The Traditional Qilu Medical University, Department of Human Anatomy Teaching and Research Office, Zibo, Shandong Province, China.
J Med Biochem. 2025 Aug 21;44(5):965-975. doi: 10.5937/jomb0-56808.
This study aimed to evaluate the effects of recurrent laryngeal nerve anatomical exposure during thyroidectomy on serum TNF-a, CRP interleukins IL-6, IL-10, and IL-1b, treatment outcomes, complications, and patient prognosis, with a specific focus on inflammatory and stress markers, including interleukins.
110 patients with thyroid lesions undergoing thyroidectomy were randomly assigned to two groups: Expose (n = 55), where the recurrent laryngeal nerve was exposed during surgery, and non-expose (n = 55), where it was not. Various outcome measures were assessed, including surgical efficacy, vocal cord function, serum inflammatory and stress markers (TNF-a, CRP interleukins IL-6, IL-10, and IL-1b), thyroid function changes, postoperative complications (including RLN I), and patient satisfaction. Additionally, quality of life (QoL) was evaluated.
The Expose group exhibited a smaller flap area and shorter hospital stays than the non-expose group, though the surgery took longer (P< 0.05). On postoperative day 30, patients in the Expose group showed lower values of fundamental frequency, Jitter, and Shimmer in vocal cords, indicating improved vocal function (P < 0 .0 5). Furthermore, the Expose group had significantly higher QoL scores and a lower incidence of RLNI (3.64% vs. 20.00% , P< 0.05), with improved surgical satisfaction (96.36% vs. 76.36% , P< 0.05). Notably, the Expose group exhibited reduced inflammatory and stress markers levels, including lower TNF-a, CRP IL-6, and IL-1b, and higher IL-10, which correlated with reduced postoperative pain and inflammation.
Anatomical exposure of the recurrent laryngeal nerve during thyroidectomy enhances postoperative recovery, reduces the incidence of RLNI, and improves both vocal and parathyroid function. It also attenuates inflammatory and stress responses, as indicated by changes in serum cytokines, thereby enhancing quality of life and patient satisfaction. This approach offers significant advantages for patients undergoing thyroidectomy for various thyroid disorders.
本研究旨在评估甲状腺切除术中喉返神经解剖暴露对血清肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、白细胞介素IL-6、IL-10和IL-1β的影响，以及对治疗效果、并发症和患者预后的影响，特别关注包括白细胞介素在内的炎症和应激标志物。
110例接受甲状腺切除术的甲状腺病变患者被随机分为两组：暴露组（n = 55），术中暴露喉返神经；非暴露组（n = 55），术中不暴露喉返神经。评估了各种结局指标，包括手术疗效、声带功能、血清炎症和应激标志物（TNF-α、CRP、白细胞介素IL-6、IL-10和IL-1β）、甲状腺功能变化、术后并发症（包括喉返神经损伤）和患者满意度。此外，还评估了生活质量（QoL）。
暴露组的皮瓣面积较小，住院时间较短，尽管手术时间较长（P < 0.05）。术后第30天，暴露组患者声带的基频、抖动和闪烁值较低，表明声带功能改善（P < 0.05）。此外，暴露组的生活质量评分显著更高，喉返神经损伤发生率更低（3.64%对20.00%，P < 0.05），手术满意度提高（96.36%对76.36%，P < 0.05）。值得注意的是，暴露组的炎症和应激标志物水平降低，包括较低的TNF-α、CRP、IL-6和IL-1β，以及较高的IL-10，这与术后疼痛和炎症减轻相关。
甲状腺切除术中喉返神经的解剖暴露可促进术后恢复，降低喉返神经损伤的发生率，并改善声带和甲状旁腺功能。如血清细胞因子变化所示，它还可减轻炎症和应激反应，从而提高生活质量和患者满意度。这种方法为因各种甲状腺疾病接受甲状腺切除术的患者提供了显著优势。
