吲哚菁绿荧光显像在免充气腔镜腋窝入路甲状腺切除术中对甲状旁腺的保护作用  

Protection of indocyanine green fluorescence imaging on parathyroid gland in gasless unilateral axillary approach endoscopic thyroidectomy surgery

作　　者：陈路阳 胡朝 叶志鹏[2] 李宁[2] 吴可人[2] 傅永清[2] Chen Luyang;Hu Zhao;Ye Zhipeng;Li Ning;Wu Keren;Fu Yongqing(Zhejiang Chinese Medical University,Hangzhou 310053,China;Hepatobiliary Pancreatic Surgery,Zhejiang Provincial Hospital of Chinese Medicine,Hangzhou 310003,China)

机构地区：[1]浙江中医药大学第一临床医学院,杭州310053 [2]浙江省中医院肝胆胰外科,杭州310003

出　　处：《中华普通外科杂志》2023年第2期105-108,共4页Chinese Journal of General Surgery

基　　金：浙江省卫生厅外科项目(2021KY837)。

摘　　要：目的探讨吲哚菁绿荧光显像技术应用于甲状腺手术中识别甲状旁腺并保护甲状旁腺功能的可行性。方法回顾性分析2021年10月至2022年5月间浙江省中医院42例免充气腔镜腋窝入路甲状腺切除术患者的临床资料,对术中使用荧光显像技术(研究组)和常规腔镜甲状腺切除术(对照组)的患者进行比较。结果研究组术中发现的甲状旁腺数为(1.57±0.61)枚,明显多于对照组的(0.56±0.59)枚(t=-5.472,P<0.05)。研究组术后第1天血清甲状旁腺素值为(2.88±1.23)pmol/L,高于对照组的(2.16±0.10)pmol/L(t=-1.844,P<0.05);第3天的血清甲状旁腺激素值为(3.22±1.31)pmol/L,较对照组的(2.55±0.81)pmol/L高(t=-2.041,P<0.05)。研究组术后发现甲状旁腺功能低下2例,少于对照组的5例,但两组比较差异无统计学意义(χ^(2)=0.942,P>0.05)。研究组术后出现低钙血症1例,对照组出现3例,差异无统计学意义(χ^(2)=0.731,P>0.05)。结论应用吲哚菁绿荧光显像技术在甲状腺手术中辨识甲状旁腺是可行的、简便快捷并且安全有效。Objective To evaluate the feasibility of indocyanine green fluorescence imaging technology applied in thyroid surgery to identify parathyroid gland.Methods From Oct 2021 to May 2022,data of 42 patients undergoing thyroidectomy via gasless unilateral axillary approach in Zhejiang Provincial Hospital of Traditional Chinese Medicine were retrospectively analyzed.Cases using intraoperative fluorescence imaging technology(42 cases)were compared with conventional laparocopic approach.Results The number of parathyroid glands dissected in the study group 1.57±0.61 was higher than that in the control group 0.56±0.59(t=-5.472,P<0.05).The PTH value of the study group was(2.88±1.23)pmol/L on the first day after operation,which was higher than that of the control group(2.16±0.10)pmol/L(t=-1.844,P<0.05).The blood parathyroid hormone value on the third day(3.22±1.31)pmol/L was higher than that of the control group(2.55±0.81)pmol/L(t=-2.041,P<0.05).There were 2 cases of hypoparathyroidism in the study group,less than 5 cases in the control group,but there was no significant difference between the two groups(χ^(2)=0.942,P>0.05).There was 1 case of hypocalcemia in the study group and 3 cases in the control group(χ^(2)=0.731,P>0.05).Conclusion Using indocyanine green fluorescence imaging technology to identify parathyroid gland is feasible,simple,fast,safe and effective.

关 键 词：甲状旁腺 吲哚花菁绿 甲状腺切除术 

分 类 号：R653[医药卫生—外科学]