纳米碳甲状旁腺淋巴负显影技术在慢性肾脏病SHPT患者手术中的应用

发布时间：2018-04-29 04:14

本文选题：纳米碳混悬液 + 慢性肾脏病　；参考：《重庆医学》2017年18期

【摘要】：目的探讨纳米碳甲状旁腺淋巴负显影技术在慢性肾脏病(CKD)继发性甲状旁腺功能亢进症(SHPT)患者手术中的应用价值。方法选择2014年6月至2015年12月该中心收治的CKD 5期SHPT患者20例,利用纳米碳混悬液局部注射结合术前甲状旁腺B超、颈部增强CT及~(99)Tc~m-甲氧异晴双时相扫描(MIBI)甲状旁腺核素显像定位诊断和术中血清全段甲状旁腺激素(iPTH)快速测定,行甲状旁腺切除术(PTX)及自体前臂移植术。结果纳米碳悬注射液后甲状腺及淋巴结迅速黑染,而目标甲状旁腺则不显色、呈肉色或淡黄色,术中视野清楚,快速剥离甲状旁腺,手术损伤小;术后血钙、血磷、血iPTH明显下降,随访至术后6个月,术前术后血钙、血磷、血碱性磷酸酶、血iPTH水平比较差异有统计学意义(P0.05)。术后患者骨痛、肌痛、皮肤瘙痒症状明显缓解,随访时间内20例患者无复发及癌变。结论纳米碳混悬液示踪剂在CKD 5期SHPT患者行PTX中能够对甲状旁腺做到实时、精准的切除,可于临床推广应用。
[Abstract]:Objective to evaluate the application of nano carbon parathyroid lymphography in patients with secondary hyperparathyroidism (SHPTT) in chronic renal disease (CKD). Methods from June 2014 to December 2015, 20 patients with CKD stage 5 SHPT who were admitted to the center from June 2014 to December 2015 were treated by local injection of nano-carbon suspension combined with preoperative parathyroid B-mode ultrasound. Contrast-enhanced CT (CT) and 99Tcm- MMEX / MIBI) were performed in the diagnosis of parathyroid gland radionuclide imaging and rapid determination of serum total parathyroid hormone (iPTHH) during operation. PTX was performed after parathyroidectomy and autogenous forearm transplantation. Results after nano-carbon suspension injection, thyroid and lymph nodes were quickly stained black, while the target parathyroid gland showed no color and was fleshy or light yellow. The visual field was clear during operation, parathyroid gland was removed quickly and the injury was small. The levels of serum calcium, phosphorus, serum alkaline phosphatase and serum iPTH were significantly lower than those before and after operation (P 0.05). The symptoms of bone pain, myalgia and pruritus were relieved. Conclusion the application of nano-carbon suspension tracer in CKD stage 5 SHPT patients with PTX can achieve real-time and accurate resection of parathyroid gland, and can be popularized and applied in clinic.
【作者单位】：贵州省肿瘤医院血液透析中心;
【基金】：贵州省科技厅科研基金[黔科合LG字(2016)7401号]
【分类号】：R653;R692

【相似文献】