【摘要】 目的：分析精细化被膜解剖联合环甲间隙显露喉返神经技术在甲状腺癌患者甲状腺全切术中的应用效果。方法：选取2022年7月—2024年7月白银市第一人民医院收治的甲状腺癌患者88例作为研究对象，按照抽签法随机分为两组。两组均行甲状腺全切术，常规组（44例）术中应用甲状腺下动脉显露喉返神经技术，精细组（44例）术中应用精细化被膜解剖联合环甲间隙显露喉返神经技术。比较两组手术相关指标、甲状腺功能指标、术后并发症发生率、复发率、声带功能。结果：两组手术时间、术中出血量、淋巴结清扫数量无显著差异（P>0.05）。术后1 d、3 d，两组甲状旁腺激素、钙离子水平均降低，但精细组高于常规组（P<0.05）。精细组甲状旁腺功能减退、喉返神经损伤、低钙血症发生率及复发率较常规组低（P<0.05）。术后1个月，两组基频、基频微扰、振幅微扰降低（P<0.05），且精细组低于常规组（P<0.001）。结论：甲状腺癌患者甲状腺全切术中行精细化被膜解剖联合环甲间隙显露喉返神经技术的效果良好，能够保护患者喉返神经，促进其甲状腺功能和声带功能恢复，降低并发症发生率及复发率。更多还原

【Abstract】 Objective: Analysis of the efficacy of combined precise capsular dissection and exposure of the recurrent laryngeal nerve via the cricothyroid space in total thyroidectomy for thyroid cancer patients. Methods: A total of 88 thyroid cancer patients admitted to Baiyin First People’s Hospital from July 2022 to July 2024 were selected as study subjects and randomly divided into two groups using a lottery method. Both groups underwent total thyroidectomy. The conventional group(44 cases) used the thyroid inferior artery exposure technique for the recurrent laryngeal nerve during surgery, while the refined group(44 cases) used the refined capsular dissection combined with the cricothyroid space exposure technique for the recurrent laryngeal nerve during surgery.The two groups were compared in terms of surgical-related indicators, thyroid function indicators, postoperative complication rates, recurrence rates, and vocal cord function. Results: There were no significant differences between the two groups in terms of surgical duration, intraoperative blood loss, and number of lymph nodes removed(P>0.05).At 1 day and 3 days postoperatively, parathyroid hormone and calcium ion levels decreased in both groups, but the refined group was higher than the conventional group(P<0.05). The incidence of hypoparathyroidism, recurrent laryngeal nerve injury, hypocalcemia, and recurrence rate was lower in the refined group than in the conventional group(P<0.05).At 1 month postoperatively, the fundamental frequency, fundamental frequency perturbation, and amplitude perturbation were reduced in both groups(P<0.05), with the refined group showing lower values than the conventional group(P<0.001).Conclusion: The combination of refined capsular dissection and exposure of the recurrent laryngeal nerve in the cricothyroid space during total thyroidectomy in thyroid cancer patients yields good results, effectively protecting the recurrent laryngeal nerve, promoting the recovery of thyroid and vocal cord function, and reducing the incidence of complications and recurrence rates.更多还原