碳纳米颗粒在继发性甲状旁腺功能亢进全甲状旁腺切除术中甲状旁腺定位中的应用。
Application of carbon nanoparticles in localization of parathyroid glands during total parathyroidectomy for secondary hyperparathyroidism.
机构信息
Department of General Surgery, Changzheng Hospital, Naval medical university, Shanghai, 200003, China.
Department of Laboratory Diagnostics, Changhai Hospital, Naval medical university, Shanghai, 200433, China.
出版信息
Am J Surg. 2020 Dec;220(6):1586-1591. doi: 10.1016/j.amjsurg.2020.04.034. Epub 2020 Apr 29.
BACKGROUND
Intraoperative imaging is used to address the challenges of parathyroidectomy, but no standard modality has been established. This study aimed to assess whether carbon nanoparticle injection is useful in localizing parathyroid glands (PGs) during parathyroidectomy.
METHODS
Patients who underwent total parathyroidectomy (TPTX) between September 2015 and November 2018 were included. The operative duration and intact parathyroid hormones (iPTH) were analyzed.
RESULTS
A total of 61 patients were included; of these, 32 with carbon nanoparticle injection (TPTX + CN group) and 29 without (TPTX group). The operative duration in the TPTX + CN group was significantly shorter (90.6 ± 21.2 vs 101.4 ± 19.4 min, P = 0.042), which is more apparent in those with normal sized PGs. For those with four enlarged PGs, iPTH levels on 1 day and 1 year postoperatively were significantly lower in the TPTX + CN group (P = 0.032 and P = 0.036, respectively).
CONCLUSION
Carbon nanoparticles are useful in the identification normal sized PGs and complete resection of enlarged PGs.
背景
术中影像学用于解决甲状旁腺切除术的挑战，但尚未建立标准模式。本研究旨在评估在甲状旁腺切除术中注射碳纳米颗粒是否有助于定位甲状旁腺（PG）。
方法
纳入 2015 年 9 月至 2018 年 11 月期间行甲状旁腺全切除术（TPTX）的患者。分析手术时间和完整甲状旁腺激素（iPTH）。
结果
共纳入 61 例患者；其中 32 例接受碳纳米颗粒注射（TPTX+CN 组），29 例未接受（TPTX 组）。TPTX+CN 组的手术时间明显缩短（90.6±21.2 分钟 vs 101.4±19.4 分钟，P=0.042），在 PG 大小正常的患者中更为明显。对于 4 个肿大的 PGs，TPTX+CN 组术后 1 天和 1 年的 iPTH 水平明显更低（P=0.032 和 P=0.036）。
结论
碳纳米颗粒有助于识别正常大小的 PGs 和切除肿大的 PGs。
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