Does Corticosteroid Have Any Beneficial Effect on Voice Change after Thyroidectomy?
Does Corticosteroid Have Any Beneficial Effect on Voice Change after Thyroidectomy?
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DOI：
10.1177/000313481307901216
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发表时间：
2013-12
期刊：
影响因子：
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通讯作者：
S. Nasiri;Shima Shafag;Z. Khorgami;Nassim Sodagari;A. Aminian;A. Hedayat
中科院分区：
文献类型：
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作者：
S. Nasiri;Shima Shafag;Z. Khorgami;Nassim Sodagari;A. Aminian;A. Hedayat
声音改变是甲状腺切除术后最常见的并发症之一。它对患者的社会交往以及经济和心理状况产生严重影响。据推测，手术部位的炎症和水肿在甲状腺切除术后声音变化中起主要作用。这项随机临床试验研究的目的是评估术前单剂量类固醇对甲状腺切除术后声音变化的影响。这是一项前瞻性随机临床试验，注册号为： IRCT201106306925N。在排除 12 条标准后，从所有确定的甲状腺全切除术候选者中选出符合条件的患者。选定的病例被随机分配到两组。一组在术前接受静脉注射地塞米松。其他组接受安慰剂。术后通过声音障碍评分（VIS）评估声音变化。 64 名患者参与了这项研究，并分为两组（地塞米松和安慰剂）。手术后第一天，地塞米松 (5) 和对照组 (13；P < 0.001) 之间的 VIS 存在显着差异。 7 天后出现这种差异，但没有统计学意义（一比三；P = 0.397）。两组的第七天 VIS 评分均较第一天显着下降 (P < 0.001)。两组均未出现明显的地塞米松并发症。术前地塞米松可能会减少甲状腺切除术后声音的变化。
Voice alteration is one of the most common complications after thyroidectomy. It has a serious effect on social communication and economic and psychosocial status of patients. It has been hypothesized that inflammation and edema in the surgery site has a major role in voice change after thyroidectomy. This randomized clinical trial study was design to evaluate the effect of a single preoperative dose of steroid on voice change after thyroidectomy. This is a prospective randomized clinical trial with registration no. IRCT201106306925N. From all definitive candidates for total thyroidectomy, eligible patients were selected after exclusion of 12 criteria. Selected cases were randomly allocated to two groups. One group received intravenous dexamethasone pre-operatively. Other group received placebo. Voice change was evaluated by Voice Impairment Score (VIS) postoperatively. Sixty-four patients were entered in the study and divided into two groups (dexamethasone and placebo). VIS was significantly different at the first day after surgery between dexamethasone (five) and controls (13; P < 0.001). This difference was seen after 7 days but without statistically significance (one vs three; P = 0.397). VIS score significantly decreased on the seventh day related to the first day (P < 0.001) in both groups. There were no significant dexamethasone complications in either group. Preoperative dexamethasone may decrease voice change after thyroidectomy.