中国医学前沿杂志（电子版）2025，Vol.17Issue(6)：40-46,7.DOI:10.12037/YXQY.2025.06-06
甲状腺结节微波消融中喉返神经损伤的危险因素——基于结节体积分层的研究
Risk factors of recurrent laryngeal nerve injury during microwave ablation of thyroid nodules:a study based on the tratification of nodule volume
摘要
Abstract
Objective To investigate the independent risk factors for recurrent laryngeal nerve(RLN)injury during microwave ablation of thyroid nodules with different volumes,and to provide evidence for clinical risk stratification.Methods Patients who underwent microwave ablation between September 2022 and August 2024 and developed RLN injury were retrospectively included in the study.Nodules were stratified into large(≥500 mm3)and small(＜500 mm3)volume groups.Each case was 1∶2 matched with controls(no RLN injury).Four categories of 22 parameters were collected,and univariate/multivariate Logistic regression analyses were performed to identify risk factors and construct predictive models.Results In the large nodules group(34 cases of injury/82 cases of control),Z-node location(OR=3.418,9 5％CI:1.326-8.809),solid structure(OR=2.795,95％CI:1.066-7.360)and anterior capsule distance＞2 mm(OR=5.097,95％CI:1.508-17.232)were independent risk factors or recurrent laryngeal nerve injury.In the small nodules group(40 cases of injury/104 cases of control),higher ablation power(OR=0.904,95％CI:0.828-0.986)was an independent protective factor for recurrent laryngeal nerve injury,and TEG spacing ≤2 mm(OR=5.717,95％CI:2.402-13.605)was an independent risk factor for recurrent laryngeal nerve injury.Conclusions RLN injury risk in large nodules correlates with anatomical location and solid-cystic composition,while small-nodule risk is influenced by energy parameters and proximity to adjacent nerves.Volume-stratified assessment optimizes personalized ablation strategies.关键词
甲状腺结节/微波消融/喉返神经/分层Key words
Thyroid nodule/Microwave ablation/Recurrent laryngeal nerve/Stratification引用本文复制引用
刘冬,胡明阳,蒲顺帆,王亚文,钱林学..甲状腺结节微波消融中喉返神经损伤的危险因素——基于结节体积分层的研究[J].中国医学前沿杂志（电子版）,2025,17(6):40-46,7.基金项目
首都卫生发展科研专项项目(首发重点攻关2022-1-2022) Capital's Funds for Health Improvement and Research(Key Breakthrough Projects 2022-1-2022) （首发重点攻关2022-1-2022）
