| Objective:Hypoparathyroidism(HP)is a major complication of thyroid surgery and is caused by parathyroid damage from various causes.The resulting hypocalcemia can lead to more obvious convulsions,arrhythmias and mental disorders in patients.The purpose of this study was to investigate whether Near-infrared autofluorescence(NIRAF)combined with carbon nanoparticles can reduce the number of parathyroid glands(PGs)miscut during surgery and protect the function of PGs.Reduce the adverse reaction caused by the damage.Methods:From January 2021 to September 2022,70 patients with bilateral thyroid cancer were prospectively analyzed in the Department of Nail and Breast Surgery,Yijishan Hospital,Wannan Medical College.The patients needed radical resection of bilateral thyroid cancer,including 17 males and 53 females,aged 23 to 72 years.Seventy patients were randomly divided into two groups according to a random number table,that is,the experimental group combining nanocarbon with NIRAF technology and the control group with nanocarbon suspension.In the experimental group,prior to unilateral thyroidectomy and central lymph node dissection,the NIRAF technology was used to detect the presence of autofluorescence in the parathyroid gland,and then the specimen was resected after the parathyroid gland was determined,with the same contralateral side.The control group was injected with nano-carbon suspension during surgery,and the parathyroid gland was identified by the negative imaging effect of nano-carbon and the surgeon’s experience.The number of lymph node dissection in region VI,the number of lymph node metastasis in region VI,the change of parathyroid hormone level,the change of blood calcium level,the number of cases with hypocalcemia symptoms after operation,the numbers of cases with parathyroid missection,the numbers of patients with parathyroid autotransplantation during operation and the numbers of long-term complications were compared and analyzed between the two groups.The results were analyzed by SPSS26.0,and the differences were compared.Results:In this study,there was no difference between the experimental group and the control group in terms of age,BMI,gender,preoperative blood calcium concentration level,preoperative PTH concentration level,surgical method,number of lesions,and maximum diameter(P>0.05),and the two groups were comparable.There was no significant difference in the number of lymph node dissection and metastasis in region VI between the two groups(P>0.05).On the first day after operation,the average concentration of parathyroid hormone in the experimental group(24.67±12.28)ng/L was higher than that in the control group(17.61±10.49)ng/L,t=2.587,P=0.012.The reduction rate of PTH was 17%(6 cases)in the experimental group and 40%(14 cases)in the control group on the first day after operation.χ~2=4.48,P=0.034.On the first day after operation,the average blood calcium concentration in the experimental group(2.11±0.15)mmol/L was higher than that in the control group(2.03±0.14)mmol/L,t=2.236,P=0.029.There was no significant difference in the average serum calcium concentration between the two groups on the third postoperative day(P>0.05).The incidence of hypocalcemia on the first day after operation was 8.6%(3 cases)in the experimental group and 28.6%(10 cases)in the control group(χ~2=4.629,P=0.031).The incidence of hypocalcemia on the first day after operation was 5.7%(2 cases)in the experimental group and 22.9%(8 cases)in the control group.χ~2=4.2,P=0.04.On the third day after surgery,there was no significant difference in the incidence of hypocalcemia and symptoms of hypocalcemia between the two groups(P>0.05).The error cutting rate of parathyroid gland in the experimental group was 11.4%(4 cases),which was lower than that in the control group(31.4%,11 cases).χ~2=4.158,P=0.041.The rate of autotransplantation of parathyroid glands was 8.6%(3 cases)in the experimental group and 34.3%(12 cases)in the control group(χ~2=6.873,P=0.009).After 6 months of telephone follow-up,no symptoms of hypoparathyroidism were found in either the experimental or the control group.Conclusion:1.NIRAF combined with nano-carbon technology can improve the detection rate of parathyroid glands in thyroid cancer surgery and effectively protect the function of parathyroid glands.2.NIRAF combined with nano-carbon technology can reduce short-term complications and the proportion of autologous transplantation after thyroid cancer surgery.3.NIRAF combined with nanocarbon technology has a high level of safety. |
PDF Full Text Request