| Objective: Through the comparative analysis of differences between the related factors of methylene blue group and conventional group,verify whether methylene blue can improve the recognition and protection of parathyroid gland during thyroid carcinoma surgery,reduce the damage rate of the parathyroid gland,provides an effective method for the protection of intraoperative parathyroid gland.Methods: The clinical data of 40 patients with papillary thyroid carcinoma(PTC)who underwent the first operation in the Department of Thyroid and Breast Surgery,Yijishan Hospital,the First Affiliated Hospital of Wannan Medical College from June 2015 to May 2016 were retrospectively analyzed..According to whether methylene blue was used during the operation,it was divided into two groups: methylene blue group(20cases)and conventional operation group(20 cases).In methylene blue group,MB was injected into the thyroid to identify and protect the parathyroid gland,then radical thyroidectomy was performed;the conventional surgery group had only radical thyroidectomy.To compare gender,age,preoperative PTH and serum calcium,intraoperative parathyroid mistakenly cut case,operation time,postoperative hospitalization days,occurrence of postoperative hypocalcemia,postoperative day 1 PTH and serum calcium,postoperative day 3 serum calcium between the two groups.We use SPSS 20.0 statistical analysis software to analyze the results by chi-square test,linear correlation test and t test respectively,and discuss the difference between the two groups.Results:The operation was successfully completed in both groups.In methylene blue group,there were 5 males and 15 females with an average age of 42.40 ±10.34 years,preoperative PTH47.07 ±15.42 pg/ml,preoperative serum calcium of 2.16±0.12mmol/L,and routine operation group of 8 males and 12 females with an average age of 42.25 ±12.46 years,preoperative PTH48.18 ±12.62 pg/ml,preoperative serum calcium 2.15 ±0.14 mmol/L.There was no significant difference between the two groups in gender,age,preoperative PTH and preoperative calcium level(P > 0.05).The operation time of methylene blue group was 98.05 ± 11.26 minutes,and that of conventional surgery group was 106.40 ± 12.996 minutes.There was significant difference between the two groups(P <0.05).There was no significant difference between the two groups in the postoperative hospitalization days(P >0.05).It was found that the miscut rate of parathyroid gland in methylene blue group was 0,which was significantly lower than that in the routine operation group(30%),and the difference between the two groups was statistically significant(P < 0.05).There were 2 cases of hypocalcemia in methylene blue group(10%)and 8 cases(40%)of routine operation group.The difference between the two groups was statistically significant(P < 0.05).The differences of PTH and serum calcium between the two groups on the first day after operation were analyzed.The results showed that the PTH in the methylene blue group was higher than that in the conventional operation group[(40.82 ± 12.98pg/ml)vs(31.88 ± 10.31pg/ml),P=0.021<0.05].The level of serum calcium in the methylene blue group was higher than that in the conventional surgery group[(2.052 ± 0.128mmol/L)vs(1.968 ± 0.109mmol/L),P=0.030<0.05].The difference of serum calcium and PTH on the first postoperative day between the two groups was statistically significant.There was no significant difference in serum calcium between the two groups on the third day after the operation(P > 0.05).Conclusion: The application of MB in thyroid cancer surgery can help identify and protect the parathyroid gland,reduce the rate of parathyroid gland injury and the incidence of postoperative hypocalcemia,improve patients’ satisfaction and prognosis recovery.Use of MB during operation can shorten the operation time to some extent,but does not prolong the postoperative hospital stay.The application of MB to protect parathyroid gland is a safe method,which is easy to operate and has high clinical application value. |
