目的 探讨分化型甲状腺癌（DTC）患者经精细化甲状腺被膜解剖技术（MCDT）联合环甲隙显露喉返神经方法（RLN）治疗的效果。 方法 选自2023年12月至2024年12月苏州大学附属第一医院收治的DTC患者，按照1∶1比例与手术方法的不同纳入A组（常规术式联合甲状腺下动脉显露喉返神经法）和B组（MCDT联合RLN）各58例，共纳入116例。两组术后均随访6个月。比较两组近期疗效（术后6个月）、围术期指标、声带功能、甲状腺功能（术前、术后6个月）、创伤应激指标（术前、术后1 d）及并发症（随访期间）。 结果 随访6个月后，B组总有效率为94.83%，高于A组的79.31%（P < 0.05）。B组住院时间短于A组（P < 0.05）。与术前比较，术后6个月，两组振幅微扰、基频微扰、标准化噪声能量（NNE）及血清甲状腺刺激抗体（TSAb）、甲状腺刺激阻断性抗体（TSBAb）、促甲状腺激素受体抗体（TRAb）水平均降低，且B组更低；两组谐波噪声比（HNR）均升高，血清甲状旁腺激素（PTH）水平均降低，B组均更高（P < 0.05）；两组血清促甲状腺激素（TSH）水平均降低，但两组比较差异无统计学意义（P > 0.05）。与术前比较，术后1 d，两组创伤应激指标水平均升高，但B组更低（P < 0.05）。B组随访期间并发症发生率更低（P < 0.05）。 结论 MCDT联合RLN治疗DTC有助于缩短住院时间，减轻患者创伤应激，并改善患者声带功能及甲状腺功能，进而提高临床疗效，且具有较高安全性。

Objective To explore the therapeutic effect of meticulous capsule dissection technique （MCDT） combined with recurrent laryngeal nerve （RLN） protection in patients with differentiated thyroid cancer （DTC）. Methods The research subjects were selected from patients with DTC who were admitted to the First Affiliated Hospital of Soochow University. The inclusion period for the cases was from December 2023 to December 2024. According to a 1∶1 ratio and different surgical methods， 58 cases were assigned to Group A （conventional surgical procedure combined with exposure of the recurrent laryngeal nerve via the inferior thyroid artery）， and 58 cases were assigned to Group B （MCDT combined with RLN）， making a total of 116 cases. Both groups were followed up for 6 months after surgery. The short-term efficacy （follow-up for 6 months）， perioperative indicators （including vocal cord function and thyroid function before and 6 months after surgery）， trauma stress indicators （before and 1 day after surgery）， and complications （during the follow-up period） of the two groups were compared. Results After 6 months of follow-up， the total effective rate of group B was 94.83%， which was higher than that of group A （79.31%， P < 0.05）. The length of hospitalization in group B was shorter than that in group A （P < 0.05）. Compared with the pre-surgery state， 6 months after surgery， both groups showed a decrease in amplitude perturbation， fundamental frequency perturbation， normalized noise energy （NNE）， and serum levels of thyroid stimulating antibody （TSAb）， thyroid stimulating blocking antibody （TSBAb）， and thyroid stimulating hormone receptor antibody （TRAb）， with lower values in group B. Both groups showed an increase in harmonic noise ratio （HNR） and a decrease in serum parathyroid hormone （PTH） levels， with higher values in group B （P < 0.05）. Both groups showed a decrease in serum thyroid stimulating hormone （TSH） levels， but there was no significant difference between the two groups （P > 0.05）. Compared with the pre-surgery state， the levels of serum trauma stress indicators increased in both groups 1 day after surgery， but the values in group B were lower （P < 0.05）. During the follow-up period， the incidence of complications in group B was lower （P < 0.05）. Conclusion The combination of MCDT and RLN can help shorten the hospitalization time， reduce traumatic stress， improve the vocal cord function and thyroid function in patients with DTC， thereby enhancing the clinical efficacy and ensuring high safety.