中国实用外科杂志

中国实用外科杂志

• 论蓍 • 上一篇    下一篇

近红外自体荧光显像技术在甲状腺肿瘤手术中辅助识别甲状旁腺有效性分析

陈志达，郗洪庆，刘培发，苗    欣，王    冰，万    政，田    文   

  1. 中国人民解放军总医院第一医学中心 普通外科医学部，北京100853
  • 出版日期:2021-08-01 发布日期:2021-08-10

  • Online:2021-08-01 Published:2021-08-10

摘要： 目的    探讨分析近红外自体荧光显像（NIRAF）技术在甲状腺肿瘤手术中辅助识别甲状旁腺的有效性。方法    回顾性分析中国人民解放军总医院第一医学中心2020-04-01—2020-10-20应用NIRAF技术实施甲状腺肿瘤手术的53例病例临床资料，设为辅助组。同时对同中心同期完成的甲状腺肿瘤手术病例资料经过倾向性评分匹配后选取53例作为对照组，与辅助组进行匹配。对比分析两组术后甲状旁腺保护情况。结果    辅助组术中识别确切甲状旁腺数目多于对照组，差异有统计学意义（P<0.05）。辅助组术后甲状旁腺激素（PTH）水平和血清钙离子浓度高于对照组，差异有统计学意义（P<0.05）。行双侧甲状腺切除的病例中，辅助组术后PTH水平和血清钙离子浓度高于对照组，差异有统计学意义（P<0.05）。通过甲状腺切除后标本观察证实，补救2枚遗漏甲状旁腺，予以重新种植。结论    NIRAF技术能够有效辅助识别甲状旁腺，进而提示外科医生对其有效保护，起到功能保护的作用，进一步提高了甲状腺手术的安全性。

关键词: 近红外自体荧光显像, 甲状腺肿瘤, 甲状旁腺, 功能保护

Abstract: Effectiveness analysis of parathyroid gland assisted recognition by near-infrared autofluorescence imaging technology in thyroid tumor surgery        CHEN Zhi-da, XI Hong-qing, LIU Pei-fa, et al. Department of General Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Corresponding author: TIAN Wen, E-mail：tianwen301_cta01@163.com
Abstract    Objective    To explore and analyze the effectiveness of parathyroid gland assisted recognition by near-infrared autofluorescence (NIRAF) imaging technology in thyroid tumor surgery. Methods    A total of 53 patients who underwent thyroid cancer surgery with NIRAF imaging technology in the First Medical Center of the People's Liberation Army General Hospital from April 1, 2020 to December 10, 2020 were retrospectively analyzed, which were named as assisted group. At the same time, 53 cases of thyroid tumor surgery in the same center selected by propensity score were matched, named as control group. Then, postoperative parathyroid function protection between two groups were compared. Results    There were more intraoperative identified parathyroid glands than those in control group, the difference was significant statisticly (P<0.05).  The postoperative parathyroid hormone (PTH) level and the serum calcium ion concentration in assisted group were higher than the control group, the difference was significant statisticly (P<0.05). The PTH level and the serum calcium ion concentration in assisted group were significantly higher than the control group in the cases of bilateral thyroid gland resection, the difference was significant statisticly (P<0.05). After inspecting by thyroid gland resection specimens, two miscutting parathyroid glands were found out and replanted. Conclusion    NIRAF imaging technology can effectively assist in the identification of parathyroid glands, thereby prompting surgeons to effectively protect them, and play a role in functional protection, which further improve the safety of thyroid surgery.

Key words: near-infrared autofluorescence imaging；thyroid tumor；parathyroid gland, function protection