甲状腺全切除术中纳米碳混悬注射液对提高甲状旁腺识别及旁腺功能保护作用的研究  

Parathyroid protection and identification by carbon nanoparticles suspension during total thyroidectomy

作　　者：高文超[1] 石臣磊[1] 石铁锋[1] 秦华东[1] Gao Wenchao Shi Chenlei Shi Tiefeng Qin Huadong(The Fourth Department of General Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbia 150086, China)

机构地区：[1]哈尔滨医科大学附属第二临床医院普外四科,150086

出　　处：《中华普通外科杂志》2016年第12期1001-1004,共4页Chinese Journal of General Surgery

基　　金：黑龙江省教育厅课题资助项目（12541490）

摘　　要：目的探讨甲状腺全切除术中采用精细被膜解剖法联合应用纳米碳混悬注射液对提高甲状旁腺辨识度及保护甲状旁腺功能的作用。方法回顾性分析本院甲状腺外科在2014年1月—2014年12月间行手术治疗的97例甲状腺乳头状癌患者的临床病理资料。术中联合应用纳米碳混悬注射液患者52例为实验组，其余45例为对照组。对比两组患者切除标本中甲状旁腺误切情况及手术前、后第1、3、7天及1个月的血清钙离子、甲状旁腺激素水平的变化情况。结果实验组1例甲状旁腺误切，误切率为1．9％（1／52）。对照组7例甲状旁腺误切，误切率为15．6％（7／45）（P〈0．05）。实验组检出甲状旁腺3．1±0．4枚／例，对照组平均检出2．6±0．3枚／例（P〈0．05）。实验组暂时性甲状旁腺功能减退发生率为19．2％（10／52），对照组暂时性甲状旁腺功能减退发生率为42．2％（19／45）（P〈0．05）。实验组术后1、3、7d甲状旁腺素水平明显高于对照组（P〈0．05）。结论纳米碳混悬注射液能够提高甲状腺癌手术中甲状旁腺的辨识度，降低甲状旁腺误切风险。Objective To evaluate carbon nanoparticles suspension in protection and identification of parathyroid in total thyroidectomy for thyroid papilloearcinoma. Methods This retrospective analysis included the clinical and pathological data of 97 patients from January 2014 to December 2014, 52 cases injected carbon nanoparticles suspension （the test group）. Serum calcium and parathyroid hormone （PTH） were measured preoperatively and on 1st, 3rd ,Tth day and one month postoperatively. Results Incidental parathyroidectomy occurred in 1 case （ 1.9% , 1/52） in test group and in 7 cases （ 15.6% ,7/45 ） in control group（P 〈0. 05 ）. The mean numbers of parathyroid glands identified intraoperatively were 3. 1± 0.4/case and 2. 6 ± 0. 3/ease respectively （ P 〈 0. 05 ）. The occurrence of temporary PTH hypofunction was 19. 2% （10/52） and 42. 2% （ 19/45 ） respectively （ P 〈 0. 05 ）. Also, test group had a higher level of PTH on postoperative day 1, 3, 7 and one month （ P 〈 0. 05 ）. Conclusions Carbon nanoparticles suspension significantly improved the identification of parathyroid gland during thyroid cancer surgery and reduced the risk of incidental parathyroid eetomy in total thyroideetomy.

关 键 词：甲状腺切除术 甲状旁腺功能减退症 纳米碳混悬注射液 

分 类 号：R736.1[医药卫生—肿瘤]