精细被膜解剖联合纳米炭示踪负显影技术对经口腔镜甲状腺手术中甲状旁腺保护的临床研究

目的:探讨精细被膜解剖联合纳米炭示踪负显影技术在经口甲状腺手术中甲状旁腺保护的应用价值。方法:回顾分析2017年4月至2019年3月经口行腔镜甲状腺手术80例患者的临床资料。对照组经口行腔镜甲状腺癌根治术,研究组在此基础上应用精细被膜解剖联合纳米炭行甲状腺癌根治术。对比分析两组术中出血量、手术时间、术后引流总量、引流时间、术后住院时间、喉返神经损伤发生率及甲状旁腺误切率;统计血钙及甲状旁腺素水平。结果:两组患者术中出血量、手术时间、术后引流总量、引流时间、术后住院时间、喉返神经损伤发生率差异无统计学意义(P>0.05);对照组中甲状旁腺误切率高于研究组,差异有统计学意义(P<0.05);研究组术后血钙、甲状旁腺激素水平高于对照组,差异有统计学意义(P<0.05)。结论:精细被膜解剖联合纳米炭示踪负显影技术利于提升经口腔前庭腔镜甲状腺手术患者的甲状旁腺辨识度,避免甲状旁腺损伤或误切,从而有效保护甲状旁腺功能。

Clinical research of meticulous capsular dissection combined with nano-carbon tracer negative development technology in parathyroid protection during transoral thyroid surgery

Objective:To explore the application of meticulous capsular dissection combined with nano-carbon tracer negative development technology in parathyroid protection during transoral thyroid surgery.Methods:The clinical data of 80 patients who underwent transoral thyroid surgery from Apr.2017 to Mar.2019 were retrospectively analyzed.The control group underwent transoral thyroidectomy.The research group applied meticulous capsular dissection combined with nano-carbon tracer.The intraoperative blood loss,operative time,postoperative drainage,drainage duration,postoperative hospital stay,recurrent laryngeal nerve injury rate and parathyroid miscut rate were analyzed between two groups.Blood calcium and parathyroid hormone levels were compared after surgery between the two groups.Results:There was no significant difference in the intraoperative blood loss,operation time,postoperative drainage,drainage duration,postoperative hospital stay and recurrent laryngeal nerve injury between two groups(P>0.05).The parathyroid miscut rate in the control group was higher than that in the study group,the difference was statistically significant(P<0.05);The serum calcium and parathyroid hormone levels of patients in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusions:Meticulous capsular dissection combined with nano-carbon tracer negative development technology is beneficial to improve the parathyroid recognition during transoral vestibular thyroid surgery,which avoids complications such as parathyroid injury or miscut and protects the parathyroid function.