【摘要】 目的 既往研究显示，甲状腺手术中应用神经监测以保护喉返神经仍存在争议。本文对比甲状腺手术中应用喉返神经监测与常规解剖暴露的差异，探讨术中喉返神经监测对喉返神经暂时性损伤及永久性损伤的保护作用及临床价值。方法 收集2018年1月至2022年12月PubMed、Embase、Web of Science、中国知网、万方及维普数据库发表的与神经监测对甲状腺手术中喉返神经保护作用相关的文献，使用Stata 14.0软件进行Meta分析。结果 本研究共纳入文献18篇，病例数12 877例，其中神经监测喉组7 718例，常规解剖暴露组5 159例。Meta分析结果显示，在甲状腺手术中，神经监测与常规解剖显露喉返神经相比，能减少喉返神经暂时性损伤(OR=0.524,95%CI:0.370～0.742,P<0.001)及永久性损伤(OR=0.371,95%CI:0.235～0.584,P<0.001)。试验序贯分析显示纳入研究的总样本足够。结论 神经监测在甲状腺手术中对喉返神经暂时性损伤和永久性损伤均具有保护作用，尤其在甲状腺癌复发等2次手术时，对喉返神经保护具有重要临床意义。更多还原

【Abstract】 Objective Previous studies and related meta-analyses have shown that the use of nerve monitoring to protect laryngeal return during thyroid surgery remains controversial.In recent years, the application and progress of nerve monitoring technology and surgery have been gradually popularized.It is necessary to re-evaluate the clinical value of nerve monitoring technology in thyroid surgery compared with routine anatomical exposure of recurrent laryngeal nerve. Methods Meta analysis was used to collect the relevant literatures published in PubMed, Embase, Web of Science, China National Knowledge Network, Wanfang and VIP databases from January 2018 to December 2022.The data were meta-analyzed using Stata 14.0 software. Results A total of 18 articles with 12 877 cases were included in this study.There were 7718 cases in the neuro-monitoring larynx group and 5159 cases in the routine anatomical exposure group.Meta-analysis showed that in thyroid surgery, nerve monitoring could not only reduce temporary injury of recurrent laryngeal nerve compared with conventional dissection(OR=0.524,95%CI:0.370-0.742,P<0.001) and reduced permanent damage to the recurrent laryngeal nerve(OR=0.371,95%CI:0.235-0.584,P<0.001).Sequential analysis showed that the total sample included in the study was sufficient. Conclusion Studies have shown that nerve monitoring has a protective effect on both temporary and permanent injury of recurrent laryngeal nerve during thyroid surgery.It is of great clinical significance for the protection of recurrent laryngeal nerve during secondary surgery such as thyroid cancer recurrence.更多还原