近红外自体荧光显像联合纳米碳手术中识别甲状旁腺的临床应用  

Clinical application of near infrared autofluorescence imaging combined with nano-carbon surgery to identify parathyroid glands

作　　者：段波峰 彭卫 钱福永[1] 范志锋 谢逸 付晓莹 郑维[1] Duan Bofeng;Peng Wei;Qian Fuyong;Fan Zhifeng;Xie Yi;Fu Xiaoying;Zheng Wei(Department of Thyroid and Breast Surgery,Shenzhen Third People′s Hospital,Shenzhen 518112,China)

机构地区：[1]深圳市第三人民医院(南方科技大学第二附属医院)甲乳外科,深圳518112

出　　处：《中国医师杂志》2025年第3期408-410,416,共4页Journal of Chinese Physician

基　　金：深圳市第三人民医院院内课题项目(G2022038)。

摘　　要：目的探讨近红外自体荧光(NIRAF)显像联合纳米碳手术中识别甲状旁腺的临床效果。方法前瞻性纳入2020年1月—2023年6月深圳市第三人民医院甲乳外科80例甲状腺癌需行双侧叶甲状腺切除+单/双侧中央区淋巴结清扫术的患者,按入院时间先后顺序分为两组,联合组(40例)采用NIRAF+纳米碳负显影识别甲状旁腺,纳米碳组(40例)单用纳米碳负显影,比较两组甲状旁腺的检出率、准确率及甲状旁腺素(术后1 d及6个月)的变化。结果两组患者甲状旁腺的检出率差异无统计学意义(P=0.65),联合组准确率高于纳米碳组,差异有统计学意义(χ^(2)=8.79,P=0.003)。联合组术后1 d甲状旁腺素水平高于纳米碳组,差异有统计学意义(Z=-1.19,P=0.03)。两组术后6个月甲状旁腺素水平差异无统计学意义(P=0.18)。结论NIRAF显像联合纳米碳负显影能提高术中甲状旁腺识别的准确率,可能降低术后暂时性甲状旁腺功能减退的发生率。ObjectiveTo investigate the clinical effect of near-infrared autofluorescence(NIRAF)imaging combined with nano-carbon in the identification of parathyroid gland.MethodsA total of 80 patients with thyroid cancer requiring bilateral thyroidectomy plus single/bilateral central area lymphatic dissection were prospectively enrolled in the Department of Thyroid and Breast Surgery of the Shenzhen Third People′s Hospital from January 2020 to June 2023.Two groups were divided in order of time of admission.In the combined group(40 cases),the parathyroid glands were identified by NIRAF+nano-carbon negative imaging.The nano-carbon group(40 cases)was negatively developed with nano-carbon alone.The detection rate and accuracy of parathyroid gland and the changes of parathyroid hormone(1 d and 6 months after operation)were compared between the two groups.ResultsThere was no significant difference in the detection rate of parathyroid glands between the two groups(P=0.65),and the accuracy rate in the combined group was higher than that in the nano-carbon group,the difference was statistically significant(χ^(2)=8.79,P=0.003).The level of parathyroid hormone in the combined group was higher than that in the nano-carbon group 1 day after surgery,and the difference was statistically significant(Z=-1.19,P=0.03).There was no significant difference in parathyroid hormone levels between the two groups 6 months after operation(P=0.18).ConclusionsNIRAF imaging combined with nano-carbon negative imaging can improve the accuracy of intraoperative parathyroid identification,and may reduce the incidence of temporary postoperative hypoparathyroidism.

关 键 词：甲状腺肿瘤 甲状旁腺 近红外自体荧光 纳米碳 

分 类 号：R736.1[医药卫生—肿瘤]