ObjectiveTo investigate the clinical value of cervical vascular color Doppler ultrasound for dignosis of nonrecurrent laryngeal nerve before thyroid surgery.
MethodsThere were 1931 cases of thyroid patients treated between January 2010 to Jule 2014, group these patients according to the results of preoperative chest radiograph examination, the chest radiograph shows abnormal vessels image were group A (45 cases), no abnormalities were group B (1886 cases). Before operaton, made patients of group A to have routine carotid duplex ultrasound to identify whether the right subclavian artery abnormalities. All patients were exposed to conventional methods of recurrent laryngeal nerve during surgery.
ResultsThe 45 patients of group A, chest angiography showed 17 cases with right subclavian artery abnormalities, they were confirmed that all the 17 patients were nonrecurrent laryngeal nerve by surgery, no damage cases. The other 28 cases showed a normal right subclavian artery and no cases of nonrecurrent laryngeal nerve. The 1886 patients in group B, surgical exploration found four cases with nonrecurrent laryngeal nerve, injury in 1 case. The 21 patients whose nonrecurrent laryngeal nerve were on the right side, there were no left side with nonrecurrent laryngeal nerve and no co-exist cases of nonrecurrent and recurrent laryngeal nerve. The average exposure time of nonrecurrent laryngeal nerve in patients of group A (17 cases) was significantly shorter than that group B[(4.28±1.08) min vs. (15.50±2.08) min, t=-15.978, P=0.000].
ConclusionsThe cervical vascular color Doppler ultrasound examination before thyroid surgery can be adjuvant used, if there is the right subclavian artery abnormalities, it showes that there is the right side nonrecurrent laryngeal nerve. So as to effectively prevent the damage of nonrecurrent laryngeal nerve during thyroid surgery.
Objective To develop and validate a nomogram based on Doppler ultrasound hemodynamics at 2 weeks post-surgery for predicting autogenous arteriovenous fistula (AVF) maturation failure. Methods Patients with end-stage renal disease who underwent first-time AVF surgery between March 2023 and September 2025 were selected. Patients were classified into the maturation group and maturation failure group according to AVF status at 6 weeks post-surgery. Predictive variables were screened using LASSO regression, and a nomogram was constructed via multivariable logistic regression. Model performance was evaluated using area under the curve (AUC), calibration curves, and decision curve analysis. Results A total of 260 patients were included. Among 260 patients, 94 (36.2%) experienced AVF maturation failure. Seven variables were selected by LASSO regression: female gender, diabetes, draining vein diameter, vascular access blood flow, pulsatility index, vein depth, and anastomotic stenosis. Multivariable logistic regression demonstrated that female gender, diabetes, smaller draining vein diameter, lower vascular access blood flow, and higher pulsatility index were independent predictors (P<0.05). The nomogram yielded an AUC of 0.924 [95%CI (0.893, 0.956)], with a bootstrap-corrected AUC of 0.912. The model showed good calibration (χ2=3.703, P=0.883) and clinical net benefit. Conclusion The established nomogram exhibits robust performance and can be integrated into the routine 2-week post-operative follow-up to facilitate early identification and individualized management of AVF maturation failure.
