静脉注射亚甲蓝选择性染色甲状旁腺时的合适输注时间和速度。
Appropriate timing and velocity of infusion for the selective staining of parathyroid glands by intravenous methylene blue.
作者信息
Traynor S, Adams J R, Andersen P, Everts E, Cohen J
机构信息
Department of Otolaryngology/Head and Neck Surgery, Oregon Health Sciences University, Portland, USA.
出版信息
Am J Surg. 1998 Jul;176(1):15-7. doi: 10.1016/s0002-9610(98)00100-7.
BACKGROUND
Intraoperative parathyroid gland (PTG) identification by selective staining using methylene blue dye (MB) infusion has been shown effective but the degree of gland staining is inconsistent.
METHODS
The effect of timing and rate of MB infusion on gland uptake was investigated in a canine model by infusing MB either rapidly over 3 to 5 minutes (n = 8) or slowly over 30 minutes (n = 4). The pattern of dye uptake in an exposed PTG was determined by standardized serial photography.
RESULTS
Earliest uptake occurred between 10 and 20 minutes after infusion, and maximum uptake averaged 21 minutes, earlier than previously described. Rate of infusion did not affect staining.
CONCLUSIONS
This rapid uptake of methylene blue by the parathyroid glands suggests that its selective intraoperative use when glands are difficult to locate intraoperatively, rather than a routine preoperative infusion, is possible without significant operative delay. Clinical experience has confirmed this impression.
背景
术中通过注入亚甲蓝染料（MB）进行选择性染色来识别甲状旁腺（PTG）已被证明是有效的，但腺体染色程度并不一致。
方法
在犬模型中，通过在3至5分钟内快速注入MB（n = 8）或在30分钟内缓慢注入MB（n = 4），研究MB注入时间和速率对腺体摄取的影响。通过标准化的系列摄影确定暴露的PTG中染料摄取模式。
结果
最早摄取发生在注入后10至20分钟之间，最大摄取平均为21分钟，比先前描述的时间更早。注入速率不影响染色。
结论
甲状旁腺对亚甲蓝的这种快速摄取表明，在术中难以定位腺体时选择性地术中使用亚甲蓝，而不是常规术前注入，是可行的，且不会造成明显的手术延迟。临床经验已证实了这一观点。
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