示踪用盐酸米托蒽醌注射液在经胸前入路腔镜甲状腺癌手术中的应用价值  

The value of mitoxantrone hydrochloride injection for tracing in endoscopic thyroidectomy via anterior chest approach for the treatment of papillary thyroid carcinoma

作　　者：宁小晶 汪洪宇 傅丽元 殷毅 花苏榕[2] Ning Xiaojing;Wang Hongyu;Fu Liyuan;Yin Yi;Hua Surong(Department of General Surgery,Beijing Longfu Hospital,Beijing 100010,China;Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京市隆福医院普外科,北京100010 [2]中国医学科学院北京协和医院基本外科,北京100730

出　　处：《中华内分泌外科杂志（中英文）》2024年第3期377-382,共6页Chinese Journal of Endocrine Surgery

基　　金：中央高水平医院临床科研业务费(2022-PUMCH-B-003)。

摘　　要：目的探讨示踪用盐酸米托蒽醌注射液在经胸前入路腔镜甲状腺癌手术中的应用价值。方法回顾性研究北京市隆福医院普通外科(北京协和医院医联体单位)自2022年9月至2024年3月收治的接受经胸前入路腔镜甲状腺癌手术的患者,分为未使用示踪剂组(对照组)和使用示踪用米托蒽醌组(示踪剂组),手术均由同一手术组医生完成。比较两组的基线及术后病理和并发症情况。结果最终有25例(13例对照组,12例示踪剂组)纳入本研究。示踪剂组和对照组分别平均清扫中央区淋巴结为(7.4±4.6)枚/每侧和(2.4±1.9)枚/每侧,示踪剂组显著多于对照组(P=0.004)。两组术后病理中均未见误切的甲状旁腺,未发生喉返神经损伤。两组在一过性低钙血症发生率方面差异无统计学意义(P=0.503),但在一过性甲状旁腺激素减低发生率方面示踪剂组为1例(1/12,8.3%),优于对照组的4例(4/13,30.8%)(P=0.009),甲状旁腺激素下降幅度示踪剂组为(5.4±8.1)pg/mL,优于对照组的(20.0±11.1)pg/mL(P=0.001)。在术后总引流液量方面,示踪剂组为(142.9±71.7)mL,多于对照组的(87.7±38.8)mL(P=0.030),但并不影响两组的拔管时间(P=0.610)。示踪剂组在术后2周观察时无皮肤穿刺点示踪剂残留。结论示踪用米托蒽醌在经胸前入路腔镜甲状腺癌手术中的应用安全可靠,能显著提高中央区淋巴结的病理数目,同时能提高甲状旁腺的辨识率,对其起到更好的保护作用,且在术后2周无皮肤穿刺点的染色剂残留,不影响美观。Objective To explore the value of mitoxantrone hydrochloride injection for tracing in endoscopic thyroidectomy(ETE)via anterior chest approach for papillary thyroid carcinoma(PTC).Methods A retrospective analysis was conducted on patients undergoing ETE via anterior chest approach for PTC admitted to Beijing Longfu Hospital(Medical Treatment Combination with Peking Union Medical College Hospital)from Sep.2022 to Mar.2024.The patients were divided into two groups:the control group(without tracer)and the tracer group(with mitoxantrone hydrochloride injection for tracing).All surgeries were performed by the same thyroid surgical team.Baseline,postoperative pathologies and complications were compared between the 2 groups.Results A total of 25 patients(13 in the control group and 12 in the tracer group)were included in this study,and the average dissection of unilateral central region lymph nodes in the tracer group was 7.4±4.6,significantly more than in the control group(2.4±1.9)(P=0.004).There were no instances of mistakenly resected parathyroid gland in the postoperative pathology or accidental injury of recurrent laryngeal nerve in either group.The incidence of transient hypocalcemia did not significantly different between the two groups(P=0.503).However,the incidence of transient hypoparathyroidism in the tracer group was 1(1/12,8.3%),significantly lower than in the control group 4(4/13,30.8%)(P=0.009).The tracer group exhibited more impressive levels in parathyroid hormone(5.4±8.1)pg/mL compared to the control group(20.0±11.1)pg/mL(P=0.001).The total volume of postoperative drainage in the tracer group(142.9±71.7)mL was more than that of the control group(87.7±38.8)mL(P=0.030).But It did not affect the extubation time in either group(P=0.610).No residual tracer was observed at the skin puncture site in the tracer group after 2 weeks.Conclusions Mitoxantrone hydrochloride injection for tracing as tracer in ETE via breast approach can increase the number of pathological lymph nodes dissection in cervical cen

关 键 词：甲状腺乳头状癌 腔镜甲状腺切除术 示踪用盐酸米托蒽醌注射液 中央区淋巴结清扫 甲状旁腺 

分 类 号：R736.1[医药卫生—肿瘤]