活性纳米碳在良性巨大甲状腺肿患者行甲状腺全切术中对甲状旁腺的保护作用

Protective effect of activated nano carbon on parathyroid glands in thyroidectomy of benign huge goiter

目的探讨活性纳米碳在良性巨大甲状腺肿患者行甲状腺全切术中对甲状旁腺的保护作用。方法将98例良性巨大甲状腺肿行甲状腺全切除术患者按住院单双号分为两组,观察组在术中先行甲状腺内活性纳米碳注射,再行甲状腺全切除术;对照组仅行甲状腺全切除术。术后随访6个月,比较两组甲状旁腺功能情况。结果切除的组织标本中有甲状旁腺者观察组3例、对照组9例,术后发生暂时性甲状旁腺功能减退(甲旁减)者观察组4例、对照组11例,两组比较P均<0.05;术后发生永久性甲旁减者观察组0例、对照组1例,两组比较P>0.05。暂时性甲旁减的恢复时间观察组明显早于对照组(P<0.05)。观察组术后24 h血清甲状旁腺素、血钙水平均高于对照组(P均<0.05)。结论在良性巨大甲状腺肿患者行甲状腺全切除术中,纳米碳的负染效应有助于甲状旁腺的识别和定位,甲状腺内注射纳米碳是安全而有效的甲状旁腺功能保护方法。

Objective To investigate the protective effect of activated nano carbon on the parathyroid glands in thyroidec- tomy of patients with benign huge goiter. Methods Ninety-eight patients who would undergo thyroidectomy of benign huge goi- ter were divided into two groups according to the admission number： the experimental group which was injected activated nano carbon into the thyroid during thyroidectomy, and the control group without any injection. Parathyroid function was compared in two groups with 6-month follow-up. Results In the reseeted tissue samples, 3 patients were found parathyroid excision in the experimental group, and 9 in the control group; transient hypoparathyroidism occurred in 4 patients of the experimental group and 11 in the control group （all P 〈0.05） ; permanent hypoparathyroidism occurred in 0 patient of the experimental group and 1 in the control group （P 〉 0. 05）. The recovery time of transient hypoparathyroidism in the experimental group was significantly shor- ter than that of the control group （P 〈0.05）. The 24-hour parathyroid hormone （PTH） and the blood calcium in the experimen- tal group were higher than those of the control group （ all P 〈 0. 05）. Conclusion In the thyroidectomy of patients with benign huge goiter, the negative staining effect of activated nano carbon helps to identify and locate the parathyroid glands, and thyroid injection of nano carbon is a safe and effective method for protecting the parathyroid function.