纳米炭负显影在甲状腺术中对甲状旁腺定位及原位保护作用的研究

Research of nano-carbon negative development for parathyroid localization and in situ protection in thyroid surgery

目的：探讨纳米炭负显影在甲状腺手术中对甲状旁腺定位及原位保护的作用。方法筛选该院2013年1～6月收治的107例甲状腺腺叶切除术患者、43例甲状腺癌联合根治术患者采用常规手术为对照组；2013年7～12月收治的102例甲状腺腺叶切除术患者，48例甲状腺癌联合根治术患者术中采用纳米炭负显影为观察组；比较两组甲状旁腺误切情况及术后血钙及甲状旁腺素（PTH）改变情况。结果病理证实甲状旁腺误切观察组发生1例，对照组发生7例；一过性低血钙观察组发生9例，对照组发生27例；永久性低血钙观察组发生0例，对照组发生5例；暂时性PTH减低观察组发生7例，对照组发生21例；永久性PTH减低观察组发生1例，对照组发生7例；两组比较差异均有统计学意义（P＜0．05）。结论纳米炭可以准确地负显影甲状旁腺而达到术中辨认和定位的目的。

Objective To investigate the significance of the nano-carbon negative development for parathyroid localization and in situ protection role in thyroid surgery.Methods 107 cases of thyroid lobectomy and 43 cases of combined radical thyroid cancer re-section by conventional operation were selected as the control group;102 cases of thyroid lobectomy and 48 cases of combined radi-cal thyroid cancer resection from July to December 2013 adopted the nano-carbon negative development as the observation group. The situation of parathyroid mistaken resection and the change of the postoperative serum calcium and parathyroid hormone （PTH） were compared between the two groups.Results The pathological exmination confirmed 1 case of parathyroid mistaken resection occurred in the observation group and 7 cases occurred in the control group;9 cases of transient hypocalcemia occurred in the ob-servation group and 27 cases in the control group;0 cases of permanent hypocalcemia occurred in the observation group and 5 cases in the control group;7 cases of temporary parathyroid hormone decrease occurred in the observation group and 2 1 cases in the con-trol group;1 case of permanently parathyroid hormone decrease occurred in the observation group and 7 cases in the control group;the differences among them were statistically significant（P〈0.05）.Conclusion The lymphatic systems between thyroid and para-thyroid are different from each other.Nano-carbon negative development can accurately and negatively develop the parathyroid to reach the goal of intraoperative identification and localization,which can be used as a novel mean for intraoperative accurate identifi-cation of parathyroid gland to protect the parathyroid function.