中国实用外科杂志

中国实用外科杂志

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近红外荧光系统对甲状腺术中甲状旁腺识别临床应用研究

柳    桢，殷德涛，王    涛，马润声，刘晨光   

  1. 郑州大学第一附属医院甲状腺外科，河南郑州 450052
  • 出版日期:2020-02-01 发布日期:2020-02-14

  • Online:2020-02-01 Published:2020-02-14

摘要： 目的    评估近红外荧光系统（near-infrared fluorescence system,NIRFs）对甲状腺术中甲状旁腺的识别效果。方法    选取2019年5～6月郑州大学第一附属医院甲状腺外一科41例行甲状腺手术的病人，术中分别通过肉眼及应用NIRFs进行甲状旁腺识别，并使用组织穿刺洗脱液的甲状旁腺素来确证其是否为甲状旁腺。结果    41例病人中，共计切除了60侧甲状腺，最终确认了106枚甲状旁腺组织。肉眼辨识确认出其中90枚，检出率为84.9%（90/106）；NIRFs确认出其中105枚，检出率为99.1%（105/106）。两者间差异具有统计学意义（P<0.01）。本研究中共有137例组织分别通过NIRFs和肉眼识别是否为甲状旁腺，NIRFs识别的准确率为85.4%（117/137），肉眼识别的准确率为79.6%（109/137）。两者间差异无统计学意义（P=0.204）。结论    NIRFs探测甲状旁腺自发荧光取得了良好的临床效果，可提高甲状腺医师对于甲状旁腺的识别能力。值得进行多研究中心的深入探究。

关键词: 甲状旁腺, 自发荧光, 近红外光, 甲状腺手术

Abstract: The use of near-infrared autofluorescence system for the detection of parathyroid glands in thyroid surgery               LIU Zhen, YIN De-tao,WANG Tao， et al. Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Corresponding author: YIN De-tao,E-mail: detaoyin@zzu.edu.cn
Abstract    Objective    To evaluate the effect of  near-infrared fluorescence system (NIRFs) in thyroid surgery. Methods    From May to June 2019, a total of 41 patients with thyroid surgery in Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University were selected. The surgeon intraoperatively identified parathyroid glands with naked eyes and NIRFs. The verification of parathyroid glands was made by parathyroid hormone( PTH) value of washout fluid from fine needle biopsy. Results    A total of 60 thyroids lobes were resected from 41 patients, and 106 parathyroid glands were verified during the process. Ninety parathyroid glands were identified with naked eyes, and the detection rate was 84.9% (90/106).One hundred and five parathyroid glands were identified with NIRFs, and the detection rate was 99.1% (105/106). There was significant statistical difference between the two methods (P<0.01). Meanwhile, a total of 137 tissues were identified by NIRFs and naked eyes, and the accuracy rate of NIRFs was 85.4% (117/137), the rate was 79.6%(109/137) with naked eyes. No statistical difference was found in the accuracy rate (P=0.204 ). Conclusion    Parathyroid auto fluorescence detection with NIRFs shows very encouraging results, which is of great help for the surgeon to identify parathyroid precisely and worth further study.

Key words: parathyroid glands；autofluorescence, near-infrared light；thyroidectomy