三种甲状旁腺识别和保护技术的效果对比研究  

Comparative study on the effects of three kinds of parathyroid recognition and protection techniques

作　　者：吴艳乐 郑伟红 李会 张进军 Wu Yanle;Zheng Weihong;Li Hui;Zhang Jinjun(Department of Thyroid and Breast Surgery,Huazhong University of Science and Technology,Wuhan Hubei Province 430030,China;Department of Geriatrics,The Affiliated Tongji Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei Province 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院甲状腺乳腺外科,武汉430030 [2]华中科技大学同济医学院附属同济医院综合医疗科,武汉430030

出　　处：《中华普外科手术学杂志（电子版）》2023年第1期87-90,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的研究三种甲状旁腺识别和保护技术的临床效果。方法前瞻性纳人2019年6月至2020年12月收治行手术治疗的甲状腺乳头状癌患者135例,随机数字表法将其分为常规组、纳米碳组与免疫胶体金法甲状旁腺快速鉴定(PTH-ICGT)组,每组各45例。常规组在术中根据术者经验对甲状旁腺进行识别和保护;纳米碳组术中使用纳米碳负显影技术对甲状旁腺进行识别;PTH-ICGT组在术中使用免疫金胶体法进行甲状旁腺鉴定并加以保护。临床数据采用统计学软件SPSS24.0分析,围手术期各项指标等计量资料采用(x士s)表示,比较采用t检验,重复测量资料采用重复测量方差分析;术后并发症等计数资料比较采用×检验。P<0.05为检验标准。结果PTH-ICGT组45例患者术中共采集样本77份,免疫胶体金法鉴定甲状旁腺的敏感度为96.2%,误诊率为0%,特异度为100%,漏诊率为3.8%,准确率为97.4%。常规组患者术后低钙血症发生率为24.4%,纳米碳组为8.9%,PTH-ICGT组为6.7%,常规组患者术后低钙血症发生率明显高于其他两组(P<0.05)。三组患者术前甲状旁腺激素(PTH)及血钙水平比较差异无统计学意义(P>0.05),术后1d、3d、5dPTH及血钙比较中,PTH-ICGT组及纳米碳组均明显高于常规组(P<0.05),而PTH-ICGT组与纳米碳组相比差异无统计学意义(P>0.05)。术后6个月三组患者均无永久性甲状旁腺功能低下发生。结论甲状腺癌手术中,PTH-ICGT技术能在术中快速鉴定甲状旁腺,且操作便捷、准确率高,对术中甲状旁腺的识别保护、降低术后相关并发症的发生、提高甲状腺手术的质量起到了促进作用,宜在临床推广使用。Objective To study the clinical effect of three kinds of parathyroid recognition and protection techniques.MethodsA total of 135 patients with papillary thyroid carcinoma who underwent surgical treatment from June 2019 to December 2020 were prospectively enrolled.They were randomly divided into conventional group,carbon nanoscale group and immunocolloidal gold rapid parathyroid identification(PTH-ICGT)group,with 45 cases in each group.In the conventional group,the parathyroid glands were identified and protected according to the surgeon's experience.During the operation,the parathyroid glands were identified by negative development of carbon nanoparticles.In the PTH-ICGT group,the parathyroid glands were identified and protected by immunogold colloid method.Statistical software SPSS 24.O was used to analyze clinical data.Measurement data of perioperative indicators were expressed as(x+s),comparison was performed by t test,repeated measurement variance was used for repeated measurement data.Postoperative complications and other counting data were compared by X test.P<0.05 was considered as the test standard.ResultsA total of 77 samples were collected from 45 patients in the PTH-ICCT group.The sensitivity,misdiagnosis rate,specificity,missed diagnosis rate,and accuracy rate of parathyroid were 96.2%,0%,100%,3.8%,and 97.4%,respectively.The incidence of postoperative hypocalcemia was 24.4%in the conventional group,8.9%in the nanocarbon group,and 6.7%in the PTH-ICCT group.The incidence of postoperative hypocalcemia in the conventional group was significantly higher than that in the other two groups(P<0.05).There was no significant difference in parathyroid hormone(PTH)and blood calcium among the three groups before operation(P>0.05).The PTH and blood calcium of the PTH-ICGT group and the nano-carbon group were significantly higher than those of the conventional group at 1,3,and 5 days after operation(P<0.05).However,there was no significant difference between PTH-ICGT group and nano-carbon group(P>0.05).No permanent h

关 键 词：甲状腺肿瘤 甲状旁腺 甲状腺切除术 免疫胶体金法 纳米管 碳 

分 类 号：R736.1[医药卫生—肿瘤]