| Objective: Through clinical comparison study of parathyroid negative paraneoplastic negative localization in parathyroidectomy,the effect of locating and identifying parathyroid glands was explored.It provides a quick,safe and effective surgical method for patients with secondary hyperparathyroidism(SHPT).It can shorten the operation time and reduce the complications of surgery while improving the success rate of the operation.Methods: Collected 40 cases of SHPT patients who were treated at the First Affiliated Hospital of Guangxi University of Chinese Medicine from December 2015 to December 2017.According to the random number table method,20 patients underwent total parathyroidectomy with autotransplantation(tPTx+AT)in the control group,and 20 patients underwent tPTx+AT combined with nano-carbon parathyroid negative development technique in the nano-carbon group.Statistical analysis software was used to analyze whether there were significant differences in the related indexes such as iPTH,calcium,phosphorus,number of parathyroidectomy,length of surgery,amount of intraoperative blood loss,number of postoperative hospital stays before and after surgery.Results:(1)There was no significant difference in gender,age,preoperative serum iPTH,calcium and phosphorus levels between the two groups(P>0.05),and the two groups were comparable.(2)In the nano-carbon group,after the injection of nano-carbon,the thyroid gland was dyed black and the non-black-stained parathyroid glands formed a sharp contrast.That is,the parathyroid gland was negatively developed,which enabled the parathyroid gland to be rapidly identified and located.(3)There was no statistical difference between the two groups in the success rate of surgery,the choice of surgical methods,the number of parathyroid glands removed,and the hospitalization stay after surgery(P>0.05).In the control group,the success rate of operation was 85%(17/20),There were 4 cases of tPTx,16 cases of tPTx+AT,74 parathyroidas were resected,averaging 3.70±0.57 cases,and the postoperative hospital stay was 10.06±4.22 days.The success rate of operation in nano-carbon group was 95%(19/20),6 cases were tPTx,14 cases were tPTx+AT,78 parathyroidas were removed,the average was 3.90±0.45 cases,The postoperative hospital stay was 8.56±2.87 days.(4)The intraoperative blood loss and operation time in the nano-carbon group were less than those in the control group(P<0.05).In the control group and nano-carbon group,intraoperative blood loss was 20.80±8.17 ml,and 15.70±7.34 ml,and the operation time was 119.25±13.32 min and 86.25±7.68 min.(5)There was no statistical difference in postoperative complications between the two groups(P>0.05).The incidence of postoperative transient hypocalcemia in the control group and nano-carbon group was 60%(12/20)and 75%(15/20).The number of severe hypocalcemia patients was 1 and 0,respectively.The number of patients with symptoms of calcification was 3 cases and 4 cases respectively.The incidence of postoperative bleeding was 20.0%(4/20)and 2 cases(2/20),two groups had no postoperative infection and recurrent laryngeal nerve injury.(6)The blood iPTH of the two groups before and after operation was statistically significant(P<0.05).The blood iPTH in the control group was 2024.62± 643.50pg/ml before operation,and 602.52±431.43pg/ml after 20 minutes after operation.The carbon nanoscale was 2021.62±586.31pg/ml,and the 20 minutes after the operation was 264.39±147.23pg/ml.The i PTH of 20 min blood was significantly lower than that of the control group after the operation in the carbon nanoscale group,with significant statistical difference(P < 0.01).The two groups of patients with the original bone pain and skin pruritus and other symptoms of discomfort after the rapid relief,the quality of sleep improved.Conclusions:(1)tPTx+AT can rapidly reduce iPTH,effectively relieve bone pain and pruritus caused by SHPT.It is an effective surgical method for the treatment of SHPT.(2)Nano-carbon negative imaging has an important role in the localization of parathyroid glands,which can reduce the operation time and intraoperative blood loss.(3)tPTx+AT combined with nano-carbon will not increase postoperative hospital stay and complications.It is a safe and effective surgical method. |
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