改良Miccoli手术在全甲状腺切除术中对甲状旁腺保护研究
发布时间：2018-11-21 10:01
【摘要】：目的甲状腺乳头状癌行传统全甲状腺切除术后常见并发症为甲状旁腺功能低下,可引起严重低钙,患者极为痛苦,且无有效替代药物,极易引起医疗纠纷。本研究探讨改良Miccoli手术在全甲状腺切除中的安全性,从而有效保护甲状旁腺。方法回顾性分析2010-07-03-2015-07-19胜利油田中心医院乳腺甲状腺外科144例全甲状腺切除的甲状腺乳头状癌患者临床资料,根据治疗方法分成纳米碳组(A组)31例、改良Miccoli组(B组)71例和传统手术组(C组)42例,分析比较3组患者术后的甲状旁腺激素水平。结果A、B、C 3组患者术后第1天甲状旁腺激素水平分别为(7.85±2.45)、(5.39±2.15)和(4.50±1.83)pg/mL,3组之间差异均有统计学意义,F=23.123,P=0.001(A、B两组t=5.092,P0.001;A、C两组t=6.697,P0.001;B、C两组t=2.223,P=0.028);A、B、C 3组患者术后第7天甲状旁腺激素水平分别为(9.61±3.32)、(8.68±2.83)和(7.50±1.90)pg/mL;术后1个月甲状旁腺激素水平分别为(22.27±6.45)、(21.24±5.01)和(12.16±4.52)pg/mL。其中A、B两组术后7d(t=1.449,P=0.150)及术后1个月(t=0.793,P=0.432)甲状旁腺激素水平差异均无统计学意义,C组甲状腺旁腺激素水平明显低于A、B两组,与该两组相比术后7d及术后1个月甲状旁腺激素水平差异均有统计学意义,(术后第7天C、A两组t=0.197,P=0.003;C、B两组t=2.403,P=0.018;术后1个月C、A两组t=7.748,P0.001,C、B两组t=9.654,P0.001)。结论在全甲状腺切除时,改良Miccoli手术与纳米碳治疗效果相当,能安全有效的保护甲状旁腺,对于纳米碳显影不佳的部分患者,改良Miccoli手术可提供另外一种安全、有效的治疗方式。
[Abstract]:Objective the common complication after traditional total thyroidectomy for papillary thyroid carcinoma is hypoparathyroidism, which can cause severe hypocalcemia, severe pain, and no effective substitute drugs, so it is easy to cause medical disputes. The purpose of this study was to investigate the safety of modified Miccoli operation in total thyroidectomy and to protect parathyroid gland effectively. Methods the clinical data of 144 patients with papillary thyroid carcinoma undergoing total thyroidectomy in Shengli Oilfield Central Hospital 2010-07-03-2015-07-19 were retrospectively analyzed. The parathyroid hormone levels in modified Miccoli group (group B) and traditional operation group (group C) were analyzed and compared. Results the levels of parathyroid hormone in group C _ 3 were (7.85 卤2.45), (卤5.39 卤2.15) and (4.50 卤1.83) pg/mL,3, respectively. P0. 001 (t0. 092, P 0. 001); Group A C, group T 6.697, P 0.001, group C, t = 2.223, P = 0.028); The levels of parathyroid hormone were (9.61 卤3.32), () 8.68 卤2.83), (and (7.50 卤1.90) pg/mL; on the 7th day after operation. The levels of parathyroid hormone were (22.27 卤6.45), (21.24 卤5.01) and (12.16 卤4.52) pg/mL. 1 month after operation, respectively. There was no significant difference in parathyroid hormone levels between group A and group A on the 7th day (t = 1.449) and 1 month after operation (t = 0.793P ~ (0.432), but the level of parathyroid gland in group C was significantly lower than that in group A (n = 1), and the level of parathyroid hormone in group C was significantly lower than that in group A (n = 1). There were significant differences in parathyroid hormone levels between the two groups on the 7th day after operation and 1 month after operation. The patients in group C were treated with CU B and group C were 2.403 and 0.018 respectively, and the two groups with Con A and C were 7.748 and 0.001 respectively at one month after operation (t = 9.654, P 0.001). Conclusion in total thyroidectomy, the modified Miccoli procedure has the same effect as that of nano-carbon therapy and can protect parathyroid gland safely and effectively. The modified Miccoli procedure can provide another kind of safety for some patients with poor nano-carbon development. Effective treatment.
【作者单位】： 胜利油田中心医院乳腺甲状腺外科;
【基金】：吴阶平医学基金会临床科研专项资助基金(320.6750.13235)
【分类号】：R736.1
[Abstract]:Objective the common complication after traditional total thyroidectomy for papillary thyroid carcinoma is hypoparathyroidism, which can cause severe hypocalcemia, severe pain, and no effective substitute drugs, so it is easy to cause medical disputes. The purpose of this study was to investigate the safety of modified Miccoli operation in total thyroidectomy and to protect parathyroid gland effectively. Methods the clinical data of 144 patients with papillary thyroid carcinoma undergoing total thyroidectomy in Shengli Oilfield Central Hospital 2010-07-03-2015-07-19 were retrospectively analyzed. The parathyroid hormone levels in modified Miccoli group (group B) and traditional operation group (group C) were analyzed and compared. Results the levels of parathyroid hormone in group C _ 3 were (7.85 卤2.45), (卤5.39 卤2.15) and (4.50 卤1.83) pg/mL,3, respectively. P0. 001 (t0. 092, P 0. 001); Group A C, group T 6.697, P 0.001, group C, t = 2.223, P = 0.028); The levels of parathyroid hormone were (9.61 卤3.32), () 8.68 卤2.83), (and (7.50 卤1.90) pg/mL; on the 7th day after operation. The levels of parathyroid hormone were (22.27 卤6.45), (21.24 卤5.01) and (12.16 卤4.52) pg/mL. 1 month after operation, respectively. There was no significant difference in parathyroid hormone levels between group A and group A on the 7th day (t = 1.449) and 1 month after operation (t = 0.793P ~ (0.432), but the level of parathyroid gland in group C was significantly lower than that in group A (n = 1), and the level of parathyroid hormone in group C was significantly lower than that in group A (n = 1). There were significant differences in parathyroid hormone levels between the two groups on the 7th day after operation and 1 month after operation. The patients in group C were treated with CU B and group C were 2.403 and 0.018 respectively, and the two groups with Con A and C were 7.748 and 0.001 respectively at one month after operation (t = 9.654, P 0.001). Conclusion in total thyroidectomy, the modified Miccoli procedure has the same effect as that of nano-carbon therapy and can protect parathyroid gland safely and effectively. The modified Miccoli procedure can provide another kind of safety for some patients with poor nano-carbon development. Effective treatment.
【作者单位】： 胜利油田中心医院乳腺甲状腺外科;
【基金】：吴阶平医学基金会临床科研专项资助基金(320.6750.13235)
【分类号】：R736.1
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