Chen Jun, Zhou Qinyi, Feng Jialin, Wang Jiadong
Department of Head and Neck Surgery, RenJi Hospital, Shanghai JiaoTong University, School of Medicine, Shanghai 200001, China.
Department of Head and Neck Surgery, RenJi Hospital, Shanghai JiaoTong University, School of Medicine, Shanghai 200001, China.
Am J Otolaryngol. 2018 Mar-Apr;39(2):138-141. doi: 10.1016/j.amjoto.2017.12.008. Epub 2017 Dec 13.
To investigate the combined use of a nanocarbon (NC) suspension and low-dose Tc-MIBI for parathyroid localization during surgery in patients with secondary hyperparathyroidism (sHPT).
Between March 2010 and September 2015, 40 patients with sHPT were enrolled in this study and were randomized to receive either low-dose Tc-MIBI+NC (group I) or low-dose Tc-MIBI (group II). Pre- and post-operative serum levels of intact PTH (iPTH), calcium and phosphorus between groups were compared and the intra-operative radioactive counts of the parathyroid glands were measured.
The post-operative iPTH level was significantly lower in patients of group I (24.2±31ng/L) than in those of group II (106±155ng/L) (P=0.03) while there were no significant differences in intra-operative parathyroid gland radioactive counts between the groups. The duration of the surgical procedure was shorter for patients of group I than patients of group II. There were no serious intra-operative or post-operative complications.
The combined use of an NC suspension and Tc-MIBI for patients with sHPT is strongly recommended for the localization of parathyroid glands during surgery and is likely to improve clinical outcomes for patients.
探讨纳米碳(NC)混悬液联合低剂量锝-甲氧基异丁基异腈(Tc-MIBI)在继发性甲状旁腺功能亢进症(sHPT)患者手术中甲状旁腺定位的应用。
2010年3月至2015年9月,40例sHPT患者纳入本研究,随机分为低剂量Tc-MIBI+NC组(I组)和低剂量Tc-MIBI组(II组)。比较两组术前和术后血清完整甲状旁腺激素(iPTH)、钙和磷水平,并测量术中甲状旁腺的放射性计数。
I组患者术后iPTH水平(24.2±31ng/L)显著低于II组(106±155ng/L)(P=0.03),而两组术中甲状旁腺放射性计数无显著差异。I组患者手术时间短于II组。未出现严重的术中或术后并发症。
强烈推荐NC混悬液联合Tc-MIBI用于sHPT患者手术中甲状旁腺定位,可能改善患者临床结局。