甲状腺手术中甲状旁腺试纸鉴别甲状旁腺的应用

Application of parathyroid test paper in identifying parathyroid gland in thyroid surgery

目的研究免疫胶体金试纸法(PTH试纸法)与在注射纳米碳后依据医师经验判断法在甲状腺癌行甲状腺切除手术中快速鉴别甲状旁腺的诊断效能比较。方法选取2020年3月—7月于首都医科大学附属友谊医院行甲状腺手术的90例患者参与试验研究,对获取的155例标本行经验判断、甲状旁腺试纸检测及病理检测。所有手术均由高年资专科医师操作完成。采用SPSS 17.0软件进行统计学分析。结果医师经验判断法判定是且病理证实是甲状旁腺的74例,病理证实非甲状旁腺81例;PTH试纸判断法判定是且病理证实的甲状旁腺130例,病理证实非甲状旁腺22例,其准确率为85.53%,远高于经验判断法准确率(47.74%),差异有统计学意义(χ^(2)=49.14,P<0.05);PTH法灵敏度为95.89%,特异度为75.94%,约登指数为0.7183,经验判断法灵敏度为81.3%,特异度为47.74%,约登指数为0.2904。结论甲状腺手术中使用PTH法辨认甲状旁腺的诊断效能高于经验判断法,联合使用能够增加术中对甲状旁腺的保护。

Objective To compare the diagnostic efficiency of colloidal gold dipstick method(PTH dipstick method)with that of doctors’experience method based on nano-carbon method for rapid identification of parathyroid gland in thyroidectomy of thyroid cancer.Methods From March to July 2020,90 patients underwent thyroid surgery in the Friendship Hospital,Capital Medical University participated in the experimental study,and 155 samples underwent empirical judgment,parathyroid dipstick and pathological examination.All operations were performed by senior specialists.SPSS statistics 17.0 software was used for statistical analysis.Results Seventy-four cases of parathyroid gland confirmed by both pathology and empirical judgment,and 81 cases of non-parathyroid gland confirmed by pathology;130 cases of parathyroid glands confirmed by both PTH dipstick method and pathology,and 22 cases of non-parathyroid glands confirmed by pathology.The accuracy rate of PTH dipstick method was 85.53%which was much higher than that of empirical judgment method(47.74%).The data were statistically significant(χ^(2)=49.14,P<0.05).The sensitivity of PTH method was 95.89%,the specificity of PTH method was 75.94%,and the Youden index was 0.7183.The sensitivity of empirical judgment method was 81.3%,the specificity of empirical judgment method was 47.74%,and the Youden index was 0.2904.Conclusions The diagnostic efficiency of the PTH method is higher than that of empirical judgment method to identify parathyroid gland in thyroid surgery.The two methods can be used together to increase the protection of parathyroid gland during operation.