中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2013年
9期
721-725
,共5页
白云城%程若川%洪文娟%马云海%钱军%张建明
白雲城%程若川%洪文娟%馬雲海%錢軍%張建明
백운성%정약천%홍문연%마운해%전군%장건명
甲状腺切除术%甲状旁腺%亚甲蓝%染色与标记
甲狀腺切除術%甲狀徬腺%亞甲藍%染色與標記
갑상선절제술%갑상방선%아갑람%염색여표기
Thyroidectomy%Parathyroid glands%Methylene blue%Staining and labeling
目的 研究和比较淋巴示踪剂在甲状腺乳头状癌手术对甲状旁腺的保护作用.方法 选取符合入组标准的121例甲状腺乳头状癌患者,在行甲状腺全切和中央区淋巴清扫手术时分为常规手术组(40例)和示踪组(81例),示踪组又分为纳米炭组(48例)和亚甲蓝组(33例),示踪组术中注射0.2m示踪剂,直视下显露并原位保护甲状旁腺及其血供,观察并记录3组患者甲状旁腺的数量、染色情况、是否出现缺血.术后行病理学检查验证甲状旁腺误切率,监测血钙及血甲状旁腺激素值比较术后低钙血症发生率.结果 甲状腺淋巴示踪未发生过敏反应和其他并发症.纳米炭组的甲状旁腺误切率为1.37％(2/146),亚甲蓝组为2.62％ (2/97),常规手术组7.14％(6/84),三组比较差异有统计学意义(x2=17.372,P＜0.05)；三组患者术后低钙血症发生率纳米炭组为10.4％ (5/48),亚甲蓝组9.1％(3/33),低于常规组的17.5％ (7/40),差异有统计学意义(x2=0.671,P=0.037);三组平均显露甲状旁腺枚数纳米炭组(3.1±0.3)枚,亚甲蓝组(2.9±0.4)枚,与常规手术组(2.3±0.3)枚相比,差异有统计学意义(F=3.78,P＜0.01).结论 在行甲状腺全切时应用淋巴示踪剂可起到保护甲状旁腺的作用.
目的 研究和比較淋巴示蹤劑在甲狀腺乳頭狀癌手術對甲狀徬腺的保護作用.方法 選取符閤入組標準的121例甲狀腺乳頭狀癌患者,在行甲狀腺全切和中央區淋巴清掃手術時分為常規手術組(40例)和示蹤組(81例),示蹤組又分為納米炭組(48例)和亞甲藍組(33例),示蹤組術中註射0.2m示蹤劑,直視下顯露併原位保護甲狀徬腺及其血供,觀察併記錄3組患者甲狀徬腺的數量、染色情況、是否齣現缺血.術後行病理學檢查驗證甲狀徬腺誤切率,鑑測血鈣及血甲狀徬腺激素值比較術後低鈣血癥髮生率.結果 甲狀腺淋巴示蹤未髮生過敏反應和其他併髮癥.納米炭組的甲狀徬腺誤切率為1.37％(2/146),亞甲藍組為2.62％ (2/97),常規手術組7.14％(6/84),三組比較差異有統計學意義(x2=17.372,P＜0.05)；三組患者術後低鈣血癥髮生率納米炭組為10.4％ (5/48),亞甲藍組9.1％(3/33),低于常規組的17.5％ (7/40),差異有統計學意義(x2=0.671,P=0.037);三組平均顯露甲狀徬腺枚數納米炭組(3.1±0.3)枚,亞甲藍組(2.9±0.4)枚,與常規手術組(2.3±0.3)枚相比,差異有統計學意義(F=3.78,P＜0.01).結論 在行甲狀腺全切時應用淋巴示蹤劑可起到保護甲狀徬腺的作用.
목적 연구화비교림파시종제재갑상선유두상암수술대갑상방선적보호작용.방법 선취부합입조표준적121례갑상선유두상암환자,재행갑상선전절화중앙구림파청소수술시분위상규수술조(40례)화시종조(81례),시종조우분위납미탄조(48례)화아갑람조(33례),시종조술중주사0.2m시종제,직시하현로병원위보호갑상방선급기혈공,관찰병기록3조환자갑상방선적수량、염색정황、시부출현결혈.술후행병이학검사험증갑상방선오절솔,감측혈개급혈갑상방선격소치비교술후저개혈증발생솔.결과 갑상선림파시종미발생과민반응화기타병발증.납미탄조적갑상방선오절솔위1.37％(2/146),아갑람조위2.62％ (2/97),상규수술조7.14％(6/84),삼조비교차이유통계학의의(x2=17.372,P＜0.05)；삼조환자술후저개혈증발생솔납미탄조위10.4％ (5/48),아갑람조9.1％(3/33),저우상규조적17.5％ (7/40),차이유통계학의의(x2=0.671,P=0.037);삼조평균현로갑상방선매수납미탄조(3.1±0.3)매,아갑람조(2.9±0.4)매,여상규수술조(2.3±0.3)매상비,차이유통계학의의(F=3.78,P＜0.01).결론 재행갑상선전절시응용림파시종제가기도보호갑상방선적작용.
Objective To research the role of lymph tracers to protect parathyroid in surgery for papillary thyroid carcinoma.Methods Patients with papillary thyroid carcinoma who met selected criteria were enrolled in this study.Patients were divided into carbon nanoparticle group,methylene blue group,and conventional surgery group.Results No significant complication occurred in the patients of carbon nanoparticle and methylene blue groups.In carbon nanoparticle group,methylene blue group and conventional surgery group,the mean numbers of parathyroid glands detected during surgery were 3.1 ± 0.3,2.9 + 0.4 and 2.3 ± 0.3 (F =3.78,P ＜ 0.01),the rates that parathyroid was cut mistakenly were 1.37％(2/146),2.62％ (2/97) and 7.14％ (6/84) respectively(x2 =17.372,P ＜ 0.05) ; and the incidence of postoperative hypocalcemia were 10.4％ (5/48),9.1％ (3/33) and 17.5％ (7/40,x2 =0.671,P =0.037).Conclusion Thyroid lymphography technique is helpful to protect from the injury to the parathyroid glands in surgery.
