探针式近红外甲状旁腺自体荧光探测技术用于腔镜甲状腺全切除术中甲状旁腺识别及功能保护的研究  

The effect of probe-based near infrared autofluorescence technology in the identification and functional protection of parathyroid gland during endoscopic total thyroidectomy

作　　者：殷廷杰 潘彬 殷素鹏 孙乙曾 侯少东 张帆 YIN Tingjie;PAN Bin;YIN Supeng;SUN Yiceng;HOU Shaodong;ZHANG Fan(Graduate School of Medicine,Chongqing Medical University,Chongqing 400016,P.R.China;Department of Breast and Thyroid Surgery,Chongqing General Hospital,Chongqing 401121,P.R.China)

机构地区：[1]重庆医科大学研究生学院,重庆400016 [2]重庆市人民医院乳腺甲状腺外科,重庆401121

出　　处：《中国普外基础与临床杂志》2024年第11期1341-1346,共6页Chinese Journal of Bases and Clinics In General Surgery

基　　金：重庆市技术创新与应用发展专项重点项目(项目编号:CSTB2022TIAD-KPX0177)。

摘　　要：目的 探讨探针式近红外甲状旁腺自体荧光探测技术用于腔镜甲状腺全切除术中甲状旁腺识别及功能保护的有效性。方法 回顾性收集重庆市人民医院2023年7月至2024年1月期间因甲状腺乳头状癌行甲状腺全切除+双侧中央区淋巴结清扫的160例患者的临床资料,术中使用探针式近红外甲状旁腺自体荧光探测技术识别甲状旁腺的80例患者归为探针组,术中使用肉眼识别甲状旁腺的80例患者归为肉眼组。分析比较2组患者的甲状旁腺发现数目、意外切除数目、原位保留数目、自体移植数目,以及术后甲状旁腺功能减退发生率和手术时间的差异。结果 探针组暂时性甲状旁腺功能减退的发生率低于肉眼组[21.25%(17/80)比43.75%(35/80),χ^(2)=9.231,P=0.002],2组均无永久性甲状旁腺功能减退发生。探针组的甲状旁腺识别数目和原位保留数目多于肉眼组(P<0.05),但甲状旁腺意外切除数目及自体移植数目少于肉眼组(P<0.05);探针组比肉眼组发现第1枚甲状旁腺的时间更早(4 min vs. 5 min,P<0.001);探针组和肉眼组的手术时间比较差异没有统计学意义(90 min vs.94 min,P=0.052)。结论 探针式近红外甲状旁腺自体荧光探测技术有助于术中更好地识别及保护甲状旁腺,并降低术后暂时性甲状旁腺功能减退的发生率。Objective To investigate the effectiveness of probe-based near infrared autofluorescence(AF)technology in the identification and functional protection of parathyroid gland(PG)during endoscopic total thyroidectomy.Methods We retrospectively collected the clinical data of 160 patients who underwent total thyroidectomy with bilateral central compartment lymph node dissection due to papillary thyroid carcinoma in Chongqing General Hospital from 1 July 2023 to 31 January 2024.Among them,80 patients who used probe-based near infrared AF technology to identify the PGs were categorized as the AF group,80 patients who used naked eye(NE)to identify the PGs were categorized as the NE group.The number of PGs identified,inadvertently removed,preserved in situ and autotransplanted,the incidence of postoperative hypoparathyroidism,and operative time were compared between the two groups.Results The incidence of transient hypoparathyroidism was significantly lower in the AF group than that of the NE group[21.25%(17/80)vs.43.75%(35/80),χ^(2)=9.231,P=0.002],with no cases of permanent hypoparathyroidism in either group.The AF group had significantly more PGs identified and preserved in situ than the NE group(P<0.05),but had significantly fewer PGs inadvertently removed and autotransplanted than the NE group(P<0.05).The AF group identified the first PG earlier than the NE group(4 min vs.5 min,P<0.001).But there was no statistically difference in the operative time between the two groups(90 min vs.94 min,P=0.052).Conclusion The probe-based near infrared AF technology can help surgeons better identify and protect PGs during surgery,reducing the incidence of postoperative transient hypoparathyroidism.

关 键 词：探针式甲状旁腺探测技术 自体荧光 甲状旁腺 甲状旁腺功能减退 甲状腺全切除 

分 类 号：R736.1[医药卫生—肿瘤]