纳米碳对甲状旁腺切除加自体移植术中甲状旁腺识别作用探讨

doi:10.3969/j.issn.1005-6483.2019.09.014

摘要/Abstract

摘要： 目的:探讨纳米碳对甲状旁腺切除加自体移植术中甲状旁腺识别作用。方法:尿毒症继发性甲状旁腺功能亢进病人74例，分为观察组（39例）和对照组（35例）。观察组采取纳米碳术中示踪的甲状旁腺切除加自体移植术；对照组采取传统的甲状旁腺切除加自体移植术；随访6个月，观察手术结果、病理诊断、血清甲状旁腺激素（PTH）、血钙水平、并发症及复发情况。结果:两组术后症状均较术前明显改善；观察组甲状旁腺组织切除准确率为100%，对照组为86.18%，差异有统计学意义（P<0.05）；两组手术切口长度、术中出血量差异均无统计学意义（P>0.05）；观察组手术时间、术后住院时间短于对照组，差异有统计学意义（P<0.05）；观察组术后1天及6个月时血清PTH、血钙水平低于对照组，差异有统计学意义（P<0.05）；两组均未见喉返神经损伤。观察组术后出现低血钙20例，对照组术后均出现不同程度的低血钙，经对症处理后缓解；随访期间，观察组复发率为0，对照组为11.43%，差异有统计学意义（P<0.05）。结论:纳米碳对甲状旁腺切除加自体移植术中异常甲状旁腺有识别作用，有助于保护甲状腺功能和喉返神经。

关键词: 尿毒症, 继发性甲状旁腺功能亢进, 甲状旁腺切除术, 自体移植, 纳米碳

Abstract: Objective:To investigate the role of nanocarbon in the recognition of parathyroid glands in parathyroidectomy plus autograft.ethods:Seventyfour patients with uremia secondary hyperparathyroidism who underwent surgery were selected as subjects，divided into observation group（39 cases）and control group（35 cases）.Observation group took parathyroidectomy and autografting traced in nanocarbon surgery，Control group underwent conventional parathyroidectomy plus autografting；followup for 6 months，observe all patients' surgical results，pathological diagnosis，serum parathyroid hormone（PTH），serum calcium levels，complications and recurrence.Results:The postoperative symptoms of the two groups were significantly improved compared with those before surgery；the accuracy of excision of parathyroid tissue in the observation group was 100%，which was significantly higher than that in the control group（86.18%），and the difference was statistically significant（P<0.05）； there was no significant difference in the length of the incision and the amount of intraoperative blood loss between the two groups（P>0.05）；the operation time and postoperative hospital stay of the observation group were significantly shorter than the control group，and the difference was statistically significant（P<0.05）；serum PTH and serum calcium levels were significantly lower in the observation group than in the control group at 1 and 6 months after operation（P<0.05）；no recurrent laryngeal nerve injury was found in either group，in the observation group，20 cases of hypocalcemia occurred after operation，the control group showed different degrees of hypocalcemia after surgery，and was relieved after symptomatic treatment；during the followup period，the recurrence rate of the observation group was 0，which was significantly lower than that of the control group（11.43%），and the difference was statistically significant（P<0.05）.Conclusion:Anocarbon has an important recognition function for parathyroidectomy plus abnormal parathyroid gland during autograft transplantation，which is helpful to protect thyroid function and recurrent laryngeal nerve，it is worthy of further research and application.

Key words: secondary hyperparathyroidism, parathyroidectomy, autograft, nanocarbon

查小应, 吴炜, 高铭等. 纳米碳对甲状旁腺切除加自体移植术中甲状旁腺识别作用探讨[J]. 临床外科杂志, 2019, 27(9): 765-768.

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