山东大学耳鼻喉眼学报 ›› 2021, Vol. 35 ›› Issue (4): 101-107.doi: 10.6040/j.issn.1673-3770.0.2020.402

• • 上一篇    下一篇

加速康复外科在甲状腺围手术期的应用

王赫1，宋西成1,2   

  1. 1. 滨州医学院, 山东 烟台 264003;
    2. 青岛大学附属烟台毓璜顶医院 耳鼻咽喉头颈外科, 山东 烟台 264000
  • 发布日期:2021-08-05
  • 通讯作者: 宋西成. E-mail:songxicheng@126.com
  • 基金资助:
    泰山学者工程资助项目(NOts20190991)

Application of enhanced recovery after surgery in the perioperative period of thyroidectomy

WANG He1,SONG Xicheng1,2   

  1. 1. Binzhou Medical University, Yantai 264003, Shandong, China;
    2. Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, Shandong, China
  • Published:2021-08-05

PDF (PC)

212

摘要： 手术为甲状腺肿瘤的主要治疗手段,常用的手术方式包括传统开放手术、腔镜手术及达芬奇机器人手术,不管采取哪种手术方式,都有严格的质量控制标准,即尽可能减小手术创伤,缩短术后恢复时间以及取得良好恢复效果。随着甲状腺手术数量日益增多,其术后康复效果引起医患双方的高度重视。在甲状腺围手术期管理工作中,采取基于加速康复外科理念的管理方法,可以大大提高围术期患者恢复效果,加快患者康复,这一先进理念及方法必将成为未来主要发展方向,就加速康复外科在甲状腺围术期应用情况进行综述。

关键词: 加速康复外科, 甲状腺手术, 围手术期, 应用现状, 发展方向

Abstract: Surgery is the main treatment for thyroid tumors. The commonly used surgical methods include traditional open surgery, endoscopic surgery, and Da Vinci robotic surgery. For any surgical technique employed, strict quality control standards should be maintained, which include minimal surgical trauma, shorter postoperative recovery time, and good recovery. With the increasing number of thyroid surgeries, the postoperative rehabilitation outcomes have attracted considerable attention from both doctors and patients. In the perioperative management of thyroid surgery, adopting a management method based on the premise of enhanced recovery after surgery(ERAS)can greatly improve and expedite the recovery of patients in the perioperative period. This innovative concept and method will surely become the springboard for future developments. The application of ERAS surgery in the perioperative period of thyroidectomy is reviewed in our paper.

Key words: Enhanced recovery after surgery, Thyroid surgery, Perioperative period, Application status, Development direction

中图分类号: 

  • R736
[1] Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation[J]. Br J Anaesth, 1997, 78(5): 606-617. doi:10.1093/bja/78.5.606.
[2] 中国加速康复外科专家组.中国加速康复外科围手术期管理专家共识(2016)[J].中华外科杂志, 2016, 54(6):413-416.doi:10.3760/cma.j.issn.0529-5815.2016.06.004.
[3] Loop T. Fast track in thoracic surgery and anaesthesia: update of concepts[J]. CurrOpinAnaesthesiol, 2016, 29(1): 20-25. doi:10.1097/ACO.0000000000000282.
[4] Maempel JF, Walmsley PJ. Enhanced recovery programmes can reduce length of stay after total knee replacement without sacrificing functional outcome at one year[J]. Ann R Coll Surg Engl, 2015, 97(8): 563-567. doi:10.1308/rcsann.2015.0016.
[5] Aniskevich S, Pai SL. Fast track anesthesia for liver transplantation: Review of the current practice[J]. World J Hepatol, 2015, 7(20): 2303-2308. doi:10.4254/wjh.v7.i20.2303.
[6] Williamsson C, Karlsson N, Sturesson C, et al. Impact of a fast-track surgery programme for pancreaticoduodenectomy[J]. Br J Surg, 2015, 102(9): 1133-1141. doi:10.1002/bjs.9856.
[7] Philp S, Carter J, Barnett C, et al. Patients' perspectives of fast-track surgery and the role of the fast-track clinical nurse consultant in gynecological oncology[J]. Holist Nurs Pract, 2015, 29(3): 158-166. doi:10.1097/HNP.0000000000000086.
[8] 中华医学会肠外肠内营养学分会加速康复外科协作组. 结直肠手术应用加速康复外科中国专家共识(2015 版)[J].中国实用外科杂志, 2015,35(8):841-843. doi:10.7504/CJPS.ISSN1005-2208.2015.08.12.
[9] 中国研究型医院学会肝胆胰外科专业委员会.肝胆胰外科术后加速康复专家共识(2015版)[J].中华消化外科杂志, 2015, 15(1):1-6. doi:10.3969/j.issn.1674-7402.2016.04.002.
[10] 中国医师协会麻醉学医师分会.促进术后康复的麻醉管理专家共识[J].中华麻醉学杂志2015,35(2):141-148. doi: 10.3760/cma.j.issn.0254-1416.2015.02.001
[11] 中国抗癌协会头颈肿瘤专业委员会,中国抗癌协会甲状腺癌专业委员会.甲状腺外科ERAS中国专家共识(2018 版)[J].中国肿瘤,2019,28(1):26-38. doi:10.11735/j.issn.1004-0242.2019.01.A004.
[12] 杨雷, 郑荣寿, 王宁, 等. 2010年中国甲状腺癌发病与死亡情况[J]. 中华预防医学杂志,2014,48(8):663-668. doi:10.3760/cma.j.issn.0253-9624.2014.08.003 YANG Lei, ZHENG Rongshou, WANG Ning, et al. Analysis of incidence and mortality of thyroid cancer in China, 2010[J]. Chinese Journal of Preventive Medicine, 2014,48(8):663-668. doi:10.3760/cma.j.issn.0253-9624.2014.08.003.
[13] Abraham N, Albayati S. Enhanced recovery after surgery programs hasten recovery after colorectal resections[J]. World J Gastrointest Surg, 2011, 3(1): 1-6. doi:10.4240/wjgs.v3.i1.1.
[14] McLeod RS, Aarts MA, Chung F, et al. Development of an enhanced recovery after surgery guideline and implementation strategy based on the knowledge-to-action cycle[J]. Ann Surg, 2015, 262(6):1016-1025. doi:10.1097/SLA.0000000000001067.
[15] Hijazi Y, Gondal U, Aziz O. A systematic review of prehabilitation programs in abdominal cancer surgery[J]. Int J Surg, 2017, 39: 156-162. doi:10.1016/j.ijsu.2017.01.111.
[16] Dronkers JJ, Lamberts H,Reutelingsperger IM, et al. Preoperative therapeutic programme for elderly patients scheduled for elective abdominal oncological surgery: a randomized controlled pilot study[J]. Clin Rehabil, 2010, 24(7): 614-622.doi:10.1177/0269215509358941.
[17] West MA, Loughney L, Lythgoe D, et al. Effect of prehabilitation on objectively measured physical fitness after neoadjuvant treatment in preoperative rectal cancer patients: a blinded interventional pilot study[J]. Br J Anaesth, 2015, 114(2): 244-251. doi:10.1093/bja/aeu318.
[18] Aarts MA, Okrainec A, Glicksman A, et al. Adoption of enhanced recovery after surgery(ERAS)strategies for colorectal surgery at academic teaching hospitals and impact on total length of hospital stay[J]. Surg Endosc, 2012, 26(2): 442-450. doi:10.1007/s00464-011-1897-5.
[19] van Stijn MF, Korkic-Halilovic I, Bakker MS, et al. Preoperative nutrition status and postoperative outcome in elderly general surgery patients: a systematic review[J]. JPEN J Parenter Enteral Nutr, 2013, 37(1): 37-43. doi:10.1177/0148607112445900.
[20] Smith I, Kranke P, Murat I, et al. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology[J]. Eur J Anaesthesiol, 2011, 28(8): 556-569. doi:10.1097/EJA.0b013e3283495ba1.
[21] McLeod R, Fitzgerald W, Sarr M, et al. Canadian Association of General Surgeons and American College of Surgeons evidence based reviews in surgery. 14-Preoperative fasting for adults to prevent perioperative complications[J]. Can J Surg, 2005, 48(5): 409-411.
[22] 贾英. 动态心电图与常规心电图在临床心脏病诊断中的应用价值[J]. 中国继续医学教育, 2018, 10(8): 103-105. JIA Ying. The value of application of dynamic electrocardiogram and routine electrocardiogram in the diagnosis of clinical heart disease[J]. China Continuing Medical Education, 2018,10(8): 103-105. doi:CNKI:SUN:LCWX.0.2019-17-104.
[23] 中华医学会麻醉学分会. 2014版中国麻醉学指南与专家共识[M]. 北京: 人民卫生出版社, 2014.
[24] Carey RM, Whelton PK, ACC/AHA Hypertension Guideline Writing Committee. Prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 American college of cardiology/American heart association hypertension guideline[J]. Ann Intern Med, 2018, 168(5): 351-358. doi:10.7326/M17-3203.
[25] Vasudeva P, Goel A, Sengottayan VK, et al. Antiplatelet drugs and the perioperative period: What every urologist needs to know[J]. Indian J Urol, 2009, 25(3): 296-301. doi:10.4103/0970-1591.56174.
[26] 中华医学会麻醉学分会. 2017版中国麻醉学指南与专家共识[M]. 北京: 人民卫生出版社, 2017.
[27] 宋西成. 加速康复外科理念在头颈肿瘤手术的应用价值[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 1-4. doi:10.6040/j.issn.1673-3770.1.2018.010. SONG Xicheng. Application value of enhanced recovery after surgery in head and neck cancer surgery[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(5): 1-4. doi:10.6040/j.issn.1673-3770.1.2018.010.
[28] 支修益, 卫生部临床路径审核专家委员会胸外科专家组.胸外科围手术期气道管理专家共识(2012年版).中国胸心血管外科临床杂志, 2013, 20(3): 251-255. doi: CNKI:SUN:ZXYX.0.2013-03-000.
[29] 多学科围手术期气道管理专家共识(2016年版)专家组. 多学科围手术期气道管理专家共识(2016年版).中国胸心血管外科临床杂志, 2016, 23(7): 641-645. doi: 10.3877/cma.j.issn.2095-8773.2016.03.01.
[30] 张宇, 宋西成. 加速康复外科理念在耳鼻咽喉头颈外科中的应用价值[J]. 中国耳鼻咽喉头颈外科, 2018, 25(5): 275-278. ZHANG Yu, SONG Xicheng. Application and prospect of enhanced recovery after surgery in otolaryngology[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2018,25(5): 275-278. doi: 10.16066/j.1672-7002.2018.05.016.
[31] 中国临床麻醉/疼痛相关专家组(统称).耳鼻咽喉头颈外科围术期气道管理专家共识[J].中国耳鼻咽喉头颈外科,2019,26(9):463-471.
[32] 王平, 谢秋萍. 腔镜甲状腺手术临床应用争议与共识[J]. 中国实用外科杂志,2015,35(1):76-78. doi: CNKI:SUN:ZGWK.0.2015-01-027.
[33] 王猛, 郑鲁明, 贺青卿, 等. 达芬奇机器人甲状腺手术650例[J]. 中国耳鼻咽喉头颈外科,2019,26(3):117-121. doi:10.16066/j.1672-7002.2019.03.001. WANG Meng, ZHENG Luming, HEQ ingqing, et al. Experience of 650 cases of thyroid surgery by da Vinci robot[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2019,26(3):117-121. doi:10.16066/j.1672-7002.2019.03.001.
[34] 田文, 张浩. 甲状腺外科能量器械应用专家共识(2017版)[J]. 中国实用外科杂志,2017,37(9):992-997. doi:10.19538/j.cjps.issn1005-2208.2017.09.14.
[35] 张彬, 安常明, 徐震纲, 等. 超声刀在甲状腺手术中的应用[J]. 中国耳鼻咽喉头颈外科, 2006, 13(6): 365-367. ZHANG Bin, AN Changming, XU Zhengang, et al. Thyroidectomy with harmonic scalpel[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2006,13(6): 365-367.doi: 10.3969/j.issn.1672-7002.2006.06.005.
[36] Shemen L. Thyroidectomy using the harmonic scalpel: analysis of 105 consecutive cases[J]. Otolaryngol Head Neck Surg, 2002, 127(4): 284-288. doi:10.1067/mhn.2002.128072.
[37] Samraj K,Gurusamy KS. Wound drains following thyroid surgery[J]. Cochrane Database Syst Rev, 2007(4): CD006099. doi:10.1002/14651858.CD006099.pub2.
[38] 刘应金, 陈卫民, 陈镜沛, 等. 甲状腺手术不置引流1218例临床分析[J]. 临床和实验医学杂志, 2006, 5(5): 529. doi: 10.3969/j.issn.1671-4695.2006.05.057.
[39] 张海东, 龚单春, 张庆翔, 等. 甲状腺手术后不置引流的技术探讨[J]. 临床耳鼻咽喉头颈外科杂志,2015,29(2):194-196. doi:10.13201/j.issn.1001-1781.2015.02.029.
[40] 孙辉, 田文. 甲状腺及甲状旁腺术中喉上神经外支保护与监测专家共识(2017版)[J]. 中国实用外科杂志,2017,37(11):1243-1249. doi:10.19538/j.cjps.issn1005-2208.2017.11.14
[41] Wu CW, Dionigi G, Barczynski M, et al. International neuromonitoring study group guidelines 2018: Part II: Optimal recurrent laryngeal nerve management for invasivethyroidcancer-incorporation of surgical, laryngeal, and neuralelectrophysiologicdata[J]. Laryngoscope, 2018, 128(Suppl 3): S18-S27. doi:10.1002/lary.27360.
[42] Selvan B, Babu S, Paul MJ, et al. Mapping the compound muscle action potentials of cricothyroid muscle using electromyography in thyroid operations: a novel method to clinically type the external branch of the superior laryngeal nerve[J]. Ann Surg, 2009, 250(2): 293-300. doi:10.1097/SLA.0b013e3181b17342.
[43] 孙辉, 刘晓莉. 甲状腺手术并发症预防及处理[J]. 中国实用外科杂志, 2012, 32(5): 356-359. SUN Hui, LIU Xiaoli. The preservation method of the recurrent laryngeal nerve and superior laryngeal nerve in the thyroid surgery[J]. Chinese Journal of Practical Surgery, 2012,32(5): 356-359.
[44] 孙辉, 刘晓莉, 付言涛, 等. 术中神经监测技术在复杂甲状腺手术中的应用[J].中国实用外科杂志,2010,30(1):66-68. doi: CNKI:SUN:ZGWK.0.2010-01-032.
[45] 王玲, 周岩, 崔玲. 喉返神经监测仪在复杂甲状腺手术中的应用效果[J]. 中国当代医药, 2019, 26(7): 42-44, 48. WANG Ling, ZHOU Yan, CUI Ling. Application effect of laryngeal recurrent nerve monitor in complicated thyroid surgery[J]. China Modern Medicine, 2019, 26(7): 42-44, 48. doi: CNKI:SUN:ZGUD.0.2019-07-013.
[46] Kuriloff DB, Sanborn KV. Rapid intraoperative localization of parathyroid glands utilizing methylene blue infusion[J]. Otolaryngol Head Neck Surg, 2004, 131(5): 616-622. doi:10.1016/j.otohns.2004.04.026.
[47] 田文, 费阳, 郗洪庆. 甲状腺手术中新技术的合理应用及展望[J]. 中国实用外科杂志, 2018, 38(6): 600-604. doi: CNKI:SUN:ZGWK.0.2018-06-004. TIAN Wen, FEI Yang, XI Hongqing. Reasonable application and prospect of new technology in treatment of thyroid disease[J]. Chinese Journal of Practical Surgery, 2018,38(6): 600-604. doi: CNKI:SUN:ZGWK.0.2018-06-004.
[48] 李金娜, 王宁宁, 刘芳菲, 等. 现场干预在外科手术部位感染目标性监测中的作用[J].中华医院感染学杂志,2012,22(12):2531-2533. doi: CNKI:SUN:ZHYY.0.2012-12-025.
[49] Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group[J]. N Engl J Med, 1996, 334(19): 1209-1215. doi:10.1056/NEJM199605093341901.
[50] Tambyraja AL, Sengupta F, MacGregor AB, et al. Patterns and clinical outcomes associated with routine intravenous sodium and fluid administration after colorectal resection[J]. World J Surg, 2004, 28(10): 1046-1051; discussion 1051-2. doi:10.1007/s00268-004-7383-7.
[51] Li JS, Jiang ZW. Clinical significance of enhanced recovery after surgeryis not only to shorten the duration of hospital stay[J]. Chin J Dig Surg, 2015, 14(1):22-24. doi: 10.3760/cma.j.issn.1673-9752.2015.01.005
[52] Legrand G, Ruscio L, Benhamou D, et al. Goal-directed fluid therapy guided by cardiac monitoring during high-risk abdominal surgery in adult patients: cost-effectiveness analysis of esophageal Doppler and arterial pulse pressure waveform analysis[J]. Value Health, 2015, 18(5): 605-613. doi:10.1016/j.jval.2015.04.005.
[53] Bozzetti F, Mariani L. Perioperative nutritional support of patients undergoing pancreatic surgery in the age of ERAS[J]. Nutrition, 2014, 30(11/12): 1267-1271. doi:10.1016/j.nut.2014.03.002.
[54] Oderda G. Challenges in the management of acute postsurgical pain[J]. Pharmacotherapy, 2012, 32(9Suppl): 6S-11S. doi:10.1002/j.1875-9114.2012.01177.x.
[55] 卢秀波,顾玲,刘征. 甲状腺手术术后出血原因及处理[J].中国实用外科杂志,2018,38(6):605-607. doi: CNKI:SUN:ZGWK.0.2018-06-006.
[56] 王刚, 江志伟. 加速康复外科推广过程中面临的挑战与对策[J]. 山东大学学报(医学版), 2019, 57(9): 24-27, 37. doi:10.6040/j.issn.1671-7554.0.2019.533. WANG Gang, JIANG Zhiwei. Challenges and countermeasures in the spread of enhanced recovery after surgery[J]. Journal of Shandong University(Health Sciences), 2019, 57(9): 24-27, 37. doi:10.6040/j.issn.1671-7554.0.2019.533.
[1] 李丹凤,陈福权,石力,王剑,许敏. 三维影像处理结合影像导航技术在进修医生鼻科围手术期教学中的应用[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 113-118.
[2] 梁程程,雷大鹏,王欣,侯波,李梅. 甲状腺结节术后患者语音评估及嗓音声学分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(3): 20-27.
[3] 徐建慧,李欣,寸晶晶,叶飞. 加速康复外科在鼻中隔偏曲矫正术围手术期的应用效果[J]. 山东大学耳鼻喉眼学报, 2021, 35(1): 21-24.
[4] 武振,房居高. 经口腔前庭腔镜甲状腺手术进展与争议[J]. 山东大学耳鼻喉眼学报, 2020, 34(3): 13-18.
[5] 郑桂彬, 张国军, 马驰, 韦树建, 孙海清, 吴国长, 郭雅文, 郑海涛, 宋西成. 经口腔前庭入路腔镜甲状腺手术在甲状腺乳头状癌中的安全效用分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(3): 58-63.
[6] 马驰,郑桂彬,孙海清,吴国长,郭雅文,孔杨,宋西成,郑海涛. 加速康复外科理念应用于甲状腺癌手术100例[J]. 山东大学耳鼻喉眼学报, 2020, 34(3): 107-110.
[7] 宋西成. 加速康复外科理念在头颈肿瘤手术的应用价值[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 1-4.
[8] 吴喜福, 孔维封, 王玮豪, 徐惠清, 戚敏, 杨钦泰. QoR-15在加速康复外科改善慢性鼻-鼻窦炎伴鼻息肉围手术期生活质量评估中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 5-8.
[9] 宋晓宇, 张宇, 李成林, 宋西成. 加速康复外科理念在慢性鼻-鼻窦炎伴鼻息肉手术治疗中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 9-12.
[10] 戚敏, 李红, 王倩, 涂翠芳, 杨钦泰, 徐惠清. 加速康复外科理念在功能性内镜鼻窦手术围手术期护理的初步应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 13-18.
[11] 刘大炜,张宇,李成林,陈秀梅,宋西成. 加速康复外科在儿童OSAS围手术期中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 19-22.
[12] 王丽,张宇,张华,刘雪艳,宋西成. 加速康复外科理念在鼻窦外科手术的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 23-26.
[13] 吕旭琴,万文锦. 阻塞性睡眠呼吸暂停低通气综合征合并高血糖患者的围手术期血糖管理[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 100-104.
[14] 钟琦. 甲状腺手术中甲状旁腺的识别和保护[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 9-11.
[15] 付亚峰, 冯肖连, 林美芳, 龙朝庆. 鼻中隔偏曲矫正术围手术期应用抗生素的临床意义[J]. 山东大学耳鼻喉眼学报, 2015, 29(6): 29-30.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 林彬,王挥戈 . 功能性内镜鼻窦手术后鼻黏膜纤毛转归的研究[J]. 山东大学耳鼻喉眼学报, 2006, 20(6): 481 -487 .
[2] 公 蕾,孙 洁,薛子超,李敬华,薛卫国 . 鼻腔鼻窦恶性肿瘤细胞周期的DNA分析[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 193 -195 .
[3] 陈文文 . 1例T/NK淋巴瘤17年演进[J]. 山东大学耳鼻喉眼学报, 2006, 20(5): 472 -472 .
[4] 栾建刚,梁传余,文艳君,李炯 . 抑制表皮生长因子受体基因表达的pSIREN-ShuttleRNAi表达载体的构建[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 4 -8 .
[5] 马敬, 钟翠萍 . 手术治疗侵犯翼腭窝的鼻咽纤维血管瘤的方法（附5例报告）[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 30 -32 .
[6] 刘强和,罗香林,耿宛平,陈 晨,雷 迅,刘芳贤,邓 明 . 快速老化小鼠的听功能和耳蜗螺旋神经元的增龄性变化[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 215 -217 .
[7] 郑鹏凌,陈卫国,易笃友,黄清秀,卢 俊 . 耳内镜下吸引清除耳道耵聍55例并文献复习[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 223 -226 .
[8] 马 敬,钟翠萍,严 星,安 飞 . 耳屏软骨修补无残余软骨的鼻中隔穿孔15例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 246 -247 .
[9] 崔哲洙,严永峰,崔春莲,金顺吉 . 嗜酸性粒细胞在变应性鼻炎合并慢性鼻窦炎的分布特点[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 250 -252 .
[10] 赵鲁新,翟 洪,潘 洁 . 超声乳化吸除联合晶状体植入治疗急性闭角型青光眼伴白内障23例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 260 -262 .
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发