显影技术在甲状腺癌术中对甲状旁腺的保护作用
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摘要
手术是治疗甲状腺癌的主要方式之一,术后甲状旁腺功能减低是严重的手术并发症,由术中误切甲状旁腺或损伤其供应血管所致。目前临床上采用精细化被膜解剖、术中甲状旁腺显影及自体移植等多种手段预防术后严重的永久性甲状旁腺功能减退。现就当下临床中常用的显影技术的原理、使用方法及应用现状进行讨论。
Surgery is one of the main approaches to treat thyroid cancer. Postoperative hypoparathyroidism is a severe surgical complication,which is caused by improper incision of parathyroid gland or damage of the supply vessels. At present,multiple clinical methods,such as meticulous capsular dissection,intraoperative imaging of parathyroid gland and autotransplantation,have been adopted to prevent the incidence of postoperative severe permanent hypoparathyroidism. In this article,the principle,application method and status of common imaging techniques in clinical practice were discussed.
Surgery is one of the main approaches to treat thyroid cancer. Postoperative hypoparathyroidism is a severe surgical complication,which is caused by improper incision of parathyroid gland or damage of the supply vessels. At present,multiple clinical methods,such as meticulous capsular dissection,intraoperative imaging of parathyroid gland and autotransplantation,have been adopted to prevent the incidence of postoperative severe permanent hypoparathyroidism. In this article,the principle,application method and status of common imaging techniques in clinical practice were discussed.
引文
[1]朱精强.甲状腺手术中甲状旁腺保护专家共识.中国实用外科杂志,2015,(7):731‐736.
[2]李理,王瑶琪,孟宪瑛,张强,陈光.纳米碳标记的淋巴导向示踪技术在甲状腺全切术中应用的研究进展.吉林大学学报(医学版),2015,41(5):1095‐1098.
[3]邓建祥,张妙华.原位甲状腺癌术中同时切除气管食管沟淋巴结的临床意义--附26例分析.新医学,2006,37(7):457‐458.
[4]杜国能,肖玉根,檀谊洪,王昆,陈庞洲.纳米碳甲状旁腺负显影技术在甲状腺癌根治术中的应用.肿瘤学杂志,2015,21(6):469‐471.
[5]张维,崔海滨,葛怀娥.纳米碳负显影甲状旁腺在甲状腺癌手术中应用价值.现代仪器与医疗,2016,22(2):50‐51.
[6]钟琦,房居高,马泓智,李平栋,冯凌.经静脉低剂量亚甲蓝甲状旁腺定位在甲状腺手术中的初步应用.中国耳鼻咽喉头颈外科,2016,23(5):247‐249.
[7]Lang BH,Wong CK,Hung HT,Wong KP,Mak KL,Au KB.Indocyanine green fluorescence angiography for quantitative evaluation of in situ parathyroid gland perfusion and function after total thyroidectomy.Surgery,2017,161(1):87‐95.
[8]龙淼云,罗定远,黄楷,黄明清,彭新治,林少建.活性纳米碳在良性巨大甲状腺肿患者行甲状腺全切术中对甲状旁腺的保护作用.山东医药,2014,54(21):10‐12.
[9]杨浚沨,李海,胡波,吴志勇,杨永刚,钟源,江学庆.纳米碳在甲状腺全切除加中央区淋巴结清扫术中对甲状旁腺的保护作用.临床耳鼻咽喉头颈外科杂志,2014,28(18):1382-1384.
[10]陈泳,单伟颖.纳米碳颗粒显色对甲状旁腺的保护作用.中国组织工程研究,2016,20(30):4476‐4482.
[11]王丹凤,马毅,邹贤,朱国华,梁秀清,李秀龙.甲状旁腺原位保护技术在甲状腺全切除术中的应用.中国现代普通外科进展,2015,18(2):118‐122.
[12]张晨嵩,喻大军,李靖,金鑫,王畏,钱军.纳米碳示踪技术在甲状腺癌手术中对甲状旁腺的保护作用.蚌埠医学院学报,2016,41(3):311‐313.
[13]李真华,葛家华,吴剑,叶果,张玉莲,黄闯.纳米炭负显影在甲状腺术中对甲状旁腺定位及原位保护作用的研究.重庆医学,2014,43(17):2127‐2129.
[14]Huang K,Luo D,Huang M,Long M,Peng X,Li H.Protection of Parathyroid Function Using Carbon Nanoparticles during Thyroid Surgery.Otolaryngol Head Neck Surg,2013,149(6):845.
[15]Li Y,Jian WH,Guo ZM,Li QL,Lin SJ,Huang HY.A metaanalysis of carbon nanoparticles for identifying lymph nodes and protecting parathyroid glands during surgery.Otolaryngol Head Neck Surg,2015,152(6):1007-1016.
[16]Serkan S,Erhan A,Mahmut M,Ersoy YE,Huseyin B,Erkan Y.Safe thyroidectomy with intraoperative methylene blue spraying.Thyroid Res,2012,5(1):1-5.
[17]王贝贝,杨洪,欧爱华.亚甲蓝在继发性甲旁亢手术中对甲状旁腺的定位作用.山东大学耳鼻喉眼学报,2016,30(2):71‐74.
[18]Zaidi N,Bucak E,Yazici P,Soundararajan S,Okoh A,Yigitbas H.The feasibility of indocyanine green fluorescence imaging for identifying and assessing the perfusion of parathyroid glands during total thyroidectomy.J Surg Oncol,2016,113(7):775-778.
[19]Vidal FJ,Karenovics W,Triponez F,Sadowski SM.Intra-Operative indocyanine green angiography of the parathyroid gland.World J Surg,2016,40(10):2378-2381.
[20]Vidal JF,Belfontali V,Sadowski SM,Karenovics W,Guigard S,Triponez F.Parathyroid gland angiography with indocyanine green fluorescence to predict parathyroid function after thyroid surgery.Br J Surg,2016,103(5):537-543.
[21]Yu HW,Chung JW,Yi JW,Song RY,Lee JH,Kwon H.Intraoperative localization of the parathyroid glands with indocyanine green and Firefly(R)technology during BABA robotic thyroidectomy.Surg Endosc,2017,31(7):3020-3027.
[22]李晓坚,周丹.纳米碳与吲哚菁绿荧光导航联合在乳腺癌前哨淋巴结活检中的应用价值探讨.中国医学创新,2017,14(11):90‐93.
[2]李理,王瑶琪,孟宪瑛,张强,陈光.纳米碳标记的淋巴导向示踪技术在甲状腺全切术中应用的研究进展.吉林大学学报(医学版),2015,41(5):1095‐1098.
[3]邓建祥,张妙华.原位甲状腺癌术中同时切除气管食管沟淋巴结的临床意义--附26例分析.新医学,2006,37(7):457‐458.
[4]杜国能,肖玉根,檀谊洪,王昆,陈庞洲.纳米碳甲状旁腺负显影技术在甲状腺癌根治术中的应用.肿瘤学杂志,2015,21(6):469‐471.
[5]张维,崔海滨,葛怀娥.纳米碳负显影甲状旁腺在甲状腺癌手术中应用价值.现代仪器与医疗,2016,22(2):50‐51.
[6]钟琦,房居高,马泓智,李平栋,冯凌.经静脉低剂量亚甲蓝甲状旁腺定位在甲状腺手术中的初步应用.中国耳鼻咽喉头颈外科,2016,23(5):247‐249.
[7]Lang BH,Wong CK,Hung HT,Wong KP,Mak KL,Au KB.Indocyanine green fluorescence angiography for quantitative evaluation of in situ parathyroid gland perfusion and function after total thyroidectomy.Surgery,2017,161(1):87‐95.
[8]龙淼云,罗定远,黄楷,黄明清,彭新治,林少建.活性纳米碳在良性巨大甲状腺肿患者行甲状腺全切术中对甲状旁腺的保护作用.山东医药,2014,54(21):10‐12.
[9]杨浚沨,李海,胡波,吴志勇,杨永刚,钟源,江学庆.纳米碳在甲状腺全切除加中央区淋巴结清扫术中对甲状旁腺的保护作用.临床耳鼻咽喉头颈外科杂志,2014,28(18):1382-1384.
[10]陈泳,单伟颖.纳米碳颗粒显色对甲状旁腺的保护作用.中国组织工程研究,2016,20(30):4476‐4482.
[11]王丹凤,马毅,邹贤,朱国华,梁秀清,李秀龙.甲状旁腺原位保护技术在甲状腺全切除术中的应用.中国现代普通外科进展,2015,18(2):118‐122.
[12]张晨嵩,喻大军,李靖,金鑫,王畏,钱军.纳米碳示踪技术在甲状腺癌手术中对甲状旁腺的保护作用.蚌埠医学院学报,2016,41(3):311‐313.
[13]李真华,葛家华,吴剑,叶果,张玉莲,黄闯.纳米炭负显影在甲状腺术中对甲状旁腺定位及原位保护作用的研究.重庆医学,2014,43(17):2127‐2129.
[14]Huang K,Luo D,Huang M,Long M,Peng X,Li H.Protection of Parathyroid Function Using Carbon Nanoparticles during Thyroid Surgery.Otolaryngol Head Neck Surg,2013,149(6):845.
[15]Li Y,Jian WH,Guo ZM,Li QL,Lin SJ,Huang HY.A metaanalysis of carbon nanoparticles for identifying lymph nodes and protecting parathyroid glands during surgery.Otolaryngol Head Neck Surg,2015,152(6):1007-1016.
[16]Serkan S,Erhan A,Mahmut M,Ersoy YE,Huseyin B,Erkan Y.Safe thyroidectomy with intraoperative methylene blue spraying.Thyroid Res,2012,5(1):1-5.
[17]王贝贝,杨洪,欧爱华.亚甲蓝在继发性甲旁亢手术中对甲状旁腺的定位作用.山东大学耳鼻喉眼学报,2016,30(2):71‐74.
[18]Zaidi N,Bucak E,Yazici P,Soundararajan S,Okoh A,Yigitbas H.The feasibility of indocyanine green fluorescence imaging for identifying and assessing the perfusion of parathyroid glands during total thyroidectomy.J Surg Oncol,2016,113(7):775-778.
[19]Vidal FJ,Karenovics W,Triponez F,Sadowski SM.Intra-Operative indocyanine green angiography of the parathyroid gland.World J Surg,2016,40(10):2378-2381.
[20]Vidal JF,Belfontali V,Sadowski SM,Karenovics W,Guigard S,Triponez F.Parathyroid gland angiography with indocyanine green fluorescence to predict parathyroid function after thyroid surgery.Br J Surg,2016,103(5):537-543.
[21]Yu HW,Chung JW,Yi JW,Song RY,Lee JH,Kwon H.Intraoperative localization of the parathyroid glands with indocyanine green and Firefly(R)technology during BABA robotic thyroidectomy.Surg Endosc,2017,31(7):3020-3027.
[22]李晓坚,周丹.纳米碳与吲哚菁绿荧光导航联合在乳腺癌前哨淋巴结活检中的应用价值探讨.中国医学创新,2017,14(11):90‐93.