Clinical Study Of Ultrasound-guided Localization Of Methylene Blue Injection For Assisting The Resection Of Parathyroid Adenoma With Hyperparathyroidism

ObjectiveTo investigate whether preoperative ultrasound-guided methylene blue injection can accurately locate parathyroid adenoma and contribute to its surgical treatment.MethodsFrom October 2017 to January 2019,40 patients in Henan people's hospital who needed surgery for parathyroid adenoma were randomly divided into methylene blue localization group and traditional localization group for prospective controlled study.Parathyroid hormone(PTH)values of the preoperative,the baseline and the postoperative of 10 minutes?20 minutes?1 day and 6 months,blood calcium values of the preoperative and the postoperative of 1 day?2 days and 6 months,operation time,intraoperative blood loss,postoperative total drainage,postoperative hospital stays,hoarseness cases and 10 minutes after surgery PTH reduction rate >50% 20 cases of the two groups were recorded.SPSS 21.0 software package was used to analyze the two groups of data.Resultsfemale: male 17:3,average age(51.20±15.35)years,tumor size(18.75±5.37)mm,preoperative PTH(540.32±302.15)Pg/ml,baseline PTH(543.48±306.43)Pg/ml,preoperative blood calcium(2.91±0.41)mmol/L,postoperative blood calcium after six months(2.27±0.13)mmol/L,postoperative hoarseness 0 case,10 minutes after surgery PTH reduction rate >50% 20 cases in the methylene blue localization group have no significant difference with female: male 15:5,average age(52.60±14.59)years,tumor size(19.10±6.68)mm,preoperative(781.18±552.37)pg/ml,baseline PTH(785.19±554.17)pg/ml,preoperative blood calcium(2.99±0.38)mmol/L,postoperative blood calcium after six months(2.29±0.10)mmol/L,postoperative hoarseness 2 cases,postoperative PTH reduction rate >50% 19 cases In the traditional positioning group(p > 0.05).The operation time(55.50±14.42)min,intraoperative blood loss(11.90±5.13)ml,postoperative hospital stays(4.43±0.75)days,postoperative drainage volume(23.15±6.96)ml,the PTH values of postoperative 10 minutes(47.21±30.66)Pg/ml,postoperative 20 minutes(28.04±15.66)Pg/ml in the methylene blue localization group are all less than the operation time(98.95±27.36)min,intraoperative blood loss(46.05±11.66)ml,postoperative hospital stays(6.00±0.63)days,postoperative drainage volume(46.05±11.66)ml,the PTH values of postoperative 10 minutes(117.79±104.76)Pg/ml,postoperative 20 minutes(55.72±50.59)Pg/ml in the traditional positioning group(t =-6.281,-3.975,-7.209,-7.540,-2.089,-2.109,p <0.05).Differences have statistical significance.ConclusionCompared with the traditional localization,the methylene blue localization can reduce the operation time,intraoperative bleeding,postoperative drainage and postoperative hospital stays.The PTH values of postoperative 10 minutes and postoperative 20 minutes in the methylene blue precise localization group were lower than those in the traditional localization group.The "parathyroid adenoma" accurately localized by methylene blue staining was easier to be removed completely.Ultrasound-guided methylene blue injection for precise localization is safe and feasible,and is helpful for the surgical treatment of parathyroid adenoma.