颗粒包埋法与匀浆注射法甲状旁腺自体移植术在甲状腺癌术中的应用  

Application of granule embeddingand homogenate injection method for parathyroid autotransplantation in thyroid cancer operation

作　　者：赵雪云[1] 李远平[1] 张英毅[1] 祝琴[1] Zhao Xueyun;Li Yuanping;Zhang Yingyi;Zhu Qin(Department of Breast and Thyroid Surgery,People’s Hospital of Leshan,Leshan,Sichuan 614000,China)

机构地区：[1]乐山市人民医院甲乳外科,四川乐山614000

出　　处：《医药前沿》2020年第34期18-19,共2页Journal of Frontiers of Medicine

摘　　要：目的:比较颗粒包埋法与匀浆注射法两种甲状旁腺自体移植术在甲状腺癌术中的应用效果。方法:选取2018年1月—2020年1月我科确诊的甲状腺乳头状癌患者88例,随机分为两组,每组44例。两组患者均接受甲状腺全切+中央区淋巴结清扫术,术中两组患者分别采用颗粒包埋法及匀浆注射法将1枚甲状旁腺行自体移植。对两组患者术前1天、术后1天、术后1周、术后1月、术后3月的甲状旁腺素水平、血钙水平以及术中甲状旁腺自体移植耗时进行比较。结果:颗粒包埋组患者PTH水平(pg/ml)及血钙水平(mmol/L)分别为:(术前1天41.34±14.43、2.27±0.12,术后1天22.13±4.91、1.93±0.14,术后1周27.24±5.88、2.04±0.12,术后1月33.15±8.83、2.14±0.09,术后3月36.48±10.82、2.25±0.13),与匀浆注射组(术前1天41.52±13.97、2.26±0.14,术后1天21.88±6.44、1.89±0.12,术后1周26.92±6.03、2.06±0.11,术后1月34.01±7.73、2.15±0.14,术后3月36.77±11.49、2.26±0.12)相比,差异无统计学意义(P>0.05)。匀浆注射法甲状旁腺自体移植所需平均时间(3.2±0.8)min,较颗粒包埋法(5.5±1.2)min短,差异有统计学意义(P<0.05)。结论:颗粒包埋法与匀浆注射法甲状旁腺自体移植均安全有效,但匀浆注射法术中操作更为方便快捷。Objective To compare the application of granule embeddingand homogenate injection method for parathyroid autotransplantation in thyroid cancer operation.Methods 88 cases of thyroid papillary carcinoma from January 2018 to January 2020 were divide into two groups randomly.All patients were underwent total thyroidectomy and central lymph node dissection.And all patients also underwent with autologous transplantation of a parathyroid gland,44 cases with granule embedding method and another with homogenate injection method.The blood calcium and PTH values preoperative,one day,one week,one month and three months after operation were compared.And the length of the time that completed the parathyroid autotransplantation was compared also.Results There were no significant differences in PTH levels(pg/ml)and serum calcium levels(mmol/L)in each time point between the granule embedding group(with the results:41.34±14.43,2.27±0.12;22.13±4.91,1.93±0.14;27.24±5.88,2.04±0.12;33.15±8.83,2.14±0.09;36.48±10.82,2.25±0.13)and homogenate injection group(with the results:41.52±13.97,2.26±0.14;21.88±6.44,1.89±0.12;26.92±6.03,2.06±0.11;34.01±7.73,2.15±0.14;36.77±11.49,2.26±0.12)(P﹥0.05).The length of the time to complete the parathyroid autotransplantation with homogenate injection method is 3.2±0.8 minutes that is short than another group’s 5.5±1.2 minutes(P﹤0.05).Conclusion Granule embeddingand homogenate injection method for parathyroid autotransplantation are both safely and effectively,but the homogenate injection method is more convenient and efficient.

关 键 词：甲状腺癌 甲状旁腺自体移植 匀浆注射法 颗粒包埋法 

分 类 号：R736.1[医药卫生—肿瘤]