复发性甲状腺癌二次手术术中不同甲状旁腺鉴定方案效果对比研究  

Comparative study of different parathyroid identification schemes during secondary operation for recurrent thyroid cancer

作　　者：闫娟[1] 石昊[1] 张雨 张杰[1] 拓明祥 田青[1] 许志平 肖吓鹏 Yan Juan;Shi Hao;Zhang Yu;Zhang Jie;Tuo Mingxiang;Tian Qing;Xu Zhiping;Xiao Xiapeng(Department of Otolaryngology Head and Nech Surgery,Yan'an People's Hospital,Yan'an Shaanxi Province 716000,China;Department of Surgical Oncology,Ningde Hospital affliated to Ningde Normal University,Ningde Fujian Province 352100,China)

机构地区：[1]延安市人民医院耳鼻咽喉头颈外科,陕西延安716000 [2]宁德师范学院附属宁德市医院肿瘤外科,福建宁德352100

出　　处：《中华普外科手术学杂志（电子版）》2023年第2期180-183,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：陕西省重点研发计划(2021SF-264)。

摘　　要：目的:研究吲哚菁绿荧光成像技术和纳米碳负显影技术在复发性甲状腺癌二次手术术中甲状旁腺鉴定的应用效果。方法:选取2018年1月至2021年12月50例甲状腺癌复发行二次手术的患者作为研究对象,采用配对分组法分为两组,各25例,观察组术中采用吲哚菁绿荧光成像技术,对照组采用纳米碳负显影技术。软件SPSS 20.0完成所有数据分析。术后并发症等计数资料采用(例)表示,组间比较行x2检验;围手术期指标、血清甲状旁腺激素(PTH)、血钙水平等计量资料采用(xˉ±s)表示,行独立样本t检验。P<0.05差异有统计学意义。结果:观察组识别甲状旁腺准确率显著高于对照组(χ^(2)=4.635,P=0.031);观察组手术费用显著低于对照组(P<0.05);与术前相比,两组患者术后3 d、1个月血清PTH、血钙水平均明显下降,且对照组明显低于观察组(P<0.05);观察组患者术后并发症总发生率显著低于对照组(P<0.05),且甲状旁腺功能减退发生率显著低于对照组[1(4.0%)vs. 8(32.0%),P=0.027]。结论:复发性甲状腺癌二次手术术中采用吲哚菁绿荧光成像技术鉴定甲状旁腺,可提高甲状旁腺识别的准确率,减少术中损伤,降低术后甲状旁腺功能减退的发生率,且更具经济优势,值得在临床推广。Objective To investigate the application of indocyanine green fluorescence imaging and negative carbon nano imaging in the identification of parathyroid glands during secondary surgery for recurrent thyroid cancer.Methods Fifty patients with recurrent thyroid cancer undergoing secondary surgery from January 2018 to December 2021 were selected as the study objects,and were divided into two groups with 25 patients in each group by paired grouping method.Indocyanine green fluorescence imaging technology was used in the observation group and negative carbon nanography technology was used in the control group.SPSS 20.0 software was used to complete all data analysis.Postoperative complications and other statistical data were represented by(examples).Comparison between groups was performed by X test.Perioperative indicators,serum parathyroid hormone(PTH),blood calcium levels and other measurement data were represented by(x+s),and independent t test was performed for comparison between groups.P<0.05 was statistically significant.Results The accuracy of parathyroid identification in the observation group was significantly higher than that in the control group(χ^(2)=4.635,P=0.031).The operation cost in observation group was significantly lower than that in control group(P<0.05).Compared with preoperative,serum PTH and blood calcium levels in 2 groups were significantly decreased 3 days and 1 month after surgery,and control groupp was significantly lower than observation group(P<0.05).The total incidence of postoperative complications in observation group was significantly lower than that in control group (P<0.05), and theincidence of hypoparathyroidism was significantly lower than that in control group [1 (4. 0%) us. 8 (32. 0%),P=0.027].Conclusionn Identification of parathyroid glands by indocyanine green fluorescence imagingtechnique during secondary surgery for recurrent thyroid cancer can improve the accuracy of parathyroididentification, reduce intraoperative injuries, and reduce the incidence of postoperative hypopa

关 键 词：甲状腺肿瘤 甲状旁腺 吲哚菁绿 纳米管 碳 

分 类 号：R736.1[医药卫生—肿瘤]