摘要
目的探讨甲状旁腺分型是否可用于甲状腺手术中甲状旁腺原位保留难易程度的判断。方法回顾性分析2014年1月至2016年6月期间在四川大学华西医院甲状(旁)腺疾病诊治中心因甲状腺良恶性结节行初次手术患者的临床资料,统计各型甲状旁腺数量,比较各型甲状旁腺的原位保留率。结果 996例患者纳入研究,术中共辨认出甲状旁腺3 269枚,平均每例患者辨认出3.3枚甲状旁腺,其中A型占77.5%(2 532/3 269),B型占22.5%(737/3 269)。A型甲状旁腺的原位保留率为77.1%(1 951/2 532),而B型为80.7%(595/737),差异有统计学意义(P=0.03)。A1型甲状旁腺的原位保留率明显高于A2型(80.5%比21.4%,P<0.001);A3型甲状旁腺不能原位保留;上位B1型甲状旁腺原位保留率高于A1型(97.5%比93.7%,P<0.01);下位A1型与B1型原位保留率接近(62.2%比65.7%,P=0.23),但二者均明显低于B2型的86.0%和B3型的90.2%(PA1比B2=0.001,PA1比B3<0.001,PB1比B2=0.004,PB1比B3=0.001)。结论甲状旁腺分型可有效评估甲状腺手术中甲状旁腺原位保留的难易程度。
Objective To evaluate whether the classification of parathyroid can be used to evaluate how difficult it is that the parathyroid glands get preserved in situ during thyroid surgery. Methods Clinical date were retrospectively collected from the patients with thyroid nodules, who had undergone the initial thyroidectomy in the Department of Thyroid Surgery, West China Hospital of Sichuan University between January 2014 and June 2016. The number of parathyroid glands was counted according to the classification of parathyroid. It got comparative analysis that the rates of parathyroid glands in situ among the different types. Results A total of 996 patients were included in the study, and 3 269 pieces of parathyroid glands were identified. The mean number of parathyroid identification was 3.3 pieces. These parathyroid glands consisted of 77.5% （2 532/3 269） type A and 22.5% （737/3 269） type B. The rate of parathyroid glands in situ was 77.1% （1 951/2 532） in type A, and 80.7% （595/737） in type B, the difference was significant （P=0.03）. And the rate of parathyroid glands in situ in type A1 was significantly higher than that in type A2 （80.5% vs 21.4%, P〈0.001）. The parathyroid of type A3 couldn＇t get preserved in situ. The rate of superior parathyroid glands in situ in type B 1 was higher than that in type A1 （97.5% vs 93.7, P〈0.01）. But the rate of inferior parathyroid glands in type B1 was closed to that in type A1 （62.2% vs 65.7%, P=0.23）, and both the rates were significant less than that in type B2 （86.0%） and in type B3 （90.2%）, PA1 vs B2=0-001, PA1 vs B3〈0.001, PB1 vs B2=0.004, PB1 vs B3=0.001. Conclusion The classification of parathyroid can be used to evaluate effectively how difficult it is that the parathyroid glands get preserved in situ during thyroid surgery.
出处
《中国普外基础与临床杂志》
CAS
2017年第4期458-463,共6页
Chinese Journal of Bases and Clinics In General Surgery
关键词
甲状腺手术
甲状旁腺分型
原位保留
thyroidectomy
classification of parathyroid
preserved in situ
作者简介
通信作者：朱精强，Email：zjq—wkys@163．com
