通过胸甲韧带寻找下位甲状旁腺的临床应用价值分析

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Abstract Objective To explore the application value of finding the lower parathyroid gland (LPG) through the pleural ligament. Methods A total of 110 patients with thyroid lesions undergoing surgical treatment who were admitted to Pizhou Hospital of Traditional Chinese Medicine from August 2018 to August 2020 were selected as the research objects. They were divided into group A (55 cases, thyroid surgery using fine capsule anatomy) and group B (55 cases, on the basis of group A, another LPG was searched through the pectoral ligament) according to a random number table. The LPG search conditions in the two groups were compared during the operation. The anatomical structure of the pleural ligament and the location of the LPG were recorded. The parathyroid function, inflammatory indexes and ostoperative complicationsof the two groups were compared before and after the operation. Results The proportion of people finding LPG in group B was higher than that in group A, the difference was statistically significant (P ＜ 0.05). The pleura ligament group B was mostly a narrow strip of fat connective tissue structure with a narrow upper and lower width. Among the 43 patients, the end point was located at the lower 1/3 of the dorsal position of the lower pole of the thyroid, and the ligament contains adipose tissue and blood vessels. Among the 55 patients in group B, 21 cases of the LPG was located around the thyroid stop of the pleural ligament, 13 cases of the LPG was located in the pleural ligament, 2 cases of the LPG were located in the neck of the thymus, and 9 cases of the LPG was located around the pleural ligament. The preoperative parathyroid hormone (PTH), C-reactive protein (CRP), and blood Ca2+ levels were compared in the two groups before surgery, the difference was not statistically significant (P ＞ 0.05). The PTH and blood Ca2+ levels at 1 day after operation in the two groups were lower than before operation, the differences were statistically significant (P ＜ 0.05), and the PTH and blood Ca2+ levels at 1 day after operation in group B were higher than group A, the differences were statistically significant (P ＜ 0.05). The level of CRP at 1 day after operation in the two groups was higher than before operation, the difference was statistically significant (P ＜ 0.05), and the level of CRP at 1 day after operation in group B was lower than group A, the difference was statistically significant (P ＜ 0.05). The overall incidence of complications in group B was lower than that in group A, the difference was statistically significant (P ＜ 0.05). Conclusion Searching for LPG through the pectoral ligament can effectively locate and retain LPG, reduce the level of inflammation, and reduce the occurrence of postoperative complications.

Key words： Thyroid surgery Pectoral ligament Lower parathyroid gland Effect

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	FENG Wei WANG Weishuai

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FENG Wei WANG Weishuai. Analysis of the clinical value of finding the lower parathyroid glands through the pleural ligament[J]. 中国医药导报, 2021, 18(18): 64-67.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I18/64

[1] 王松，谢秋萍，王平，等.全腔镜甲状腺手术热点与难点[J].临床外科杂志，2020，28（3）：224-226.
[2] 张浩，刘金钢.努力减少甲状腺手术并发症[J].中国实用外科杂志，2018，38（6）：13-16.
[3] 缪英杰，吴宝潮，夏飞.甲状腺癌手术中甲状旁腺损伤的发生情况以及相关危险因素分析[J].实用癌症杂志，2019， 34（5）：812-814.
[4] Wojda SJ，Donahue SW. Parathyroid hormone for bone regeneration [J]. J Orthop Res，2018，36（10）：2586-2594.
[5] Guilmette J，Sadow PM. Parathyroid pathology [J]. Surg Pathol Clin，2019，12（4）：1007-1019.
[6] 殷德涛，赵波.甲状腺手术中甲状旁腺保护要点与技巧[J].中国实用外科杂志，2018，38（6）：615-619.
[7] 肖海.甲状腺癌手术导致喉返神经损伤的临床分析[J].河北医药，2019，41（4）：595-597.
[8] 倪帮高，麦刚，刘航，等.甲状腺癌再手术中甲状旁腺损伤及功能保护方法[J].中华内分泌外科杂志，2018，12（4）：300-303.
[9] 王之伟，李爱东.再次甲状腺手术中神经监测技术的应用[J].中国现代普通外科进展，2019，22（9）：91-94.
[10] 张一鸣，蔡相军，李医明.甲状腺术中甲状旁腺的识别与保护及术后低钙血症的诊断与治疗[J].医学综述，2018， 24（2）：347-351.
[11] 汪玖川，李明，王明虎.内镜下甲状腺全切与近全切除术中甲状旁腺保护[J].现代仪器与医疗，2019，25（4）：29-31.
[12] 李慧，彭小伟，李赞，等.改良经口入路腔镜甲状腺手术的临床应用分析[J].中华外科杂志，2019，57（9）：686-690.
[13] 朱一鸣，刘绍严.再谈甲状腺手术喉返神经损伤的相关因素[J].中国实用外科杂志，2018，38（6）：607-612.
[14] 张丽，高太虎. 甲状腺切除术后甲状旁腺功能减退的临床研究[J].肿瘤研究与临床，2020，32（11）：790-793.
[15] Jason DS，Balentine CJ. Intraoperative decision making in parathyroid surgery [J]. Surg Clin North Am，2019，99（4）：681-691.
[16] 李会政，王玲，殷文斌.甲状腺全切术中甲状旁腺保护的诊治体会[J].大连医科大学学报，2018，40（6）：67-69.
[17] 王玲，刘琳，崔玲，等.甲状腺手术中喉返神经显露的处理方式探讨[J].大连医科大学学报，2018，40（3）：247-249.
[18] Zbaren P，Shah JP，Randolph GW，et al. Thyroid Surgery：Whose domain is it [J]. Adv Ther，2019，36（10）：2541-2546.
[19] 唐乐辉，陈浪，朱之坤.甲状旁腺及其血供原位保护的临床研究[J].重庆医学，2019，48（6）：138-139.
[20] 张浩，孙威.能量器械对甲状旁腺的保护[J].外科理论与实践，2018，23（2）：96-98.
[21] 斯岩，蔡晶昇，张浩，等.下位甲状旁腺原位保留新探索——胸甲韧带精细解剖法[J].中华内分泌外科杂志，2019，13（4）：278-282.
[22] 王平，吴国洋，田文，等.经口腔前庭入路腔镜甲状腺手术专家共识（2018版）[J].中国实用外科杂志，2018，38（10）：21-24.
[23] 中国医师协会外科医师分会甲状腺外科医师委员会，中国研究型医院学会甲状腺疾病专业委员会，中国医学装备协会外科装备分会甲状腺外科装备委员会，等.开放性甲状腺手术的切口管理专家共识（2018版）[J].中华内分泌外科杂志，2018，12（4）：269-273.
[24] 朱精强，田文，苏安平.甲状腺围手术期甲状旁腺功能保护指南（2018版）[J].中国实用外科杂志，2018，38（10）：25-30.
[25] Mueller AH，Pototschnig C. Recurrent laryngeal nerve stimulator [J]. Otolaryngol Clin North Am，2020，53（1）：145-156.