甲状腺切除术中保护甲状旁腺的新方法：囊下注射生理盐水。
Novel method to save the parathyroid gland during thyroidectomy: Subcapsular saline injection.
作者信息
Choi June Young, Yu Hyeong Won, Bae In Eui, Kim Jong-Kyu, Seong Chan Yong, Yi Jin Wook, Chai Young Jun, Kim Su-Jin, Lee Kyu Eun
机构信息
Department of Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea.
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
出版信息
Head Neck. 2018 Apr;40(4):801-807. doi: 10.1002/hed.25068. Epub 2018 Jan 22.
BACKGROUND
Saving the parathyroid gland during thyroidectomy remains challenging. Subcapsular saline injection (SCASI) was developed in February 2015. Its ability to spare the parathyroid gland was assessed.
METHODS
All consecutive patients who underwent total thyroidectomy with or without neck lymph node dissection in 2013-2015 were included in this retrospective cohort study. Patients were divided into the SCASI and non-SCASI groups. Serum parathyroid hormone (PTH) levels were measured on day 1 and 6 months after surgery. Transient and permanent hypoparathyroidism were defined as day 1 and 6 month PTH < 10.0 and <15.0 pg/mL, respectively.
RESULTS
The groups (both had 98 patients each) did not differ in demographics, tumor size, operation extent, pathology, thyroiditis rate, and incidental parathyroid gland excision rate. Compared with non-SCASI patients, patients who underwent the SCASI method exhibited transient hypoparathyroidism (35.7% vs 19.4%, P < .001) and permanent hypoparathyroidism (4.1% vs 0%, P = .043) significantly less frequently.
CONCLUSION
The procedure of SCASI effectively spared the parathyroid gland during thyroidectomy.
背景
甲状腺切除术中保留甲状旁腺仍然具有挑战性。2015年2月研发了包膜下盐水注射法（SCASI）。评估了其保留甲状旁腺的能力。
方法
本回顾性队列研究纳入了2013年至2015年期间所有连续接受全甲状腺切除术（无论是否行颈部淋巴结清扫）的患者。患者被分为SCASI组和非SCASI组。在术后第1天和6个月测量血清甲状旁腺激素（PTH）水平。短暂性和永久性甲状旁腺功能减退分别定义为术后第1天和6个月时PTH＜10.0和＜15.0 pg/mL。
结果
两组（每组均有98例患者）在人口统计学、肿瘤大小、手术范围、病理、甲状腺炎发生率和意外甲状旁腺切除率方面无差异。与非SCASI患者相比，采用SCASI方法的患者短暂性甲状旁腺功能减退（35.7%对19.4%，P＜0.001）和永久性甲状旁腺功能减退（4.1%对0%，P = 0.043）的发生率明显更低。
结论
SCASI方法在甲状腺切除术中有效地保留了甲状旁腺。
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