本文選題：納米碳混懸液 + 慢性腎臟病�。� 參考：《重慶醫(yī)學(xué)》2017年18期

【摘要】：目的探討納米碳甲狀旁腺淋巴負(fù)顯影技術(shù)在慢性腎臟病(CKD)繼發(fā)性甲狀旁腺功能亢進(jìn)癥(SHPT)患者手術(shù)中的應(yīng)用價(jià)值。方法選擇2014年6月至2015年12月該中心收治的CKD 5期SHPT患者20例,利用納米碳混懸液局部注射結(jié)合術(shù)前甲狀旁腺B超、頸部增強(qiáng)CT及~(99)Tc~m-甲氧異晴雙時(shí)相掃描(MIBI)甲狀旁腺核素顯像定位診斷和術(shù)中血清全段甲狀旁腺激素(iPTH)快速測定,行甲狀旁腺切除術(shù)(PTX)及自體前臂移植術(shù)。結(jié)果納米碳懸注射液后甲狀腺及淋巴結(jié)迅速黑染,而目標(biāo)甲狀旁腺則不顯色、呈肉色或淡黃色,術(shù)中視野清楚,快速剝離甲狀旁腺,手術(shù)損傷小;術(shù)后血鈣、血磷、血iPTH明顯下降,隨訪至術(shù)后6個(gè)月,術(shù)前術(shù)后血鈣、血磷、血堿性磷酸酶、血iPTH水平比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后患者骨痛、肌痛、皮膚瘙癢癥狀明顯緩解,隨訪時(shí)間內(nèi)20例患者無復(fù)發(fā)及癌變。結(jié)論納米碳混懸液示蹤劑在CKD 5期SHPT患者行PTX中能夠?qū)谞钆韵僮龅綄?shí)時(shí)、精準(zhǔn)的切除,可于臨床推廣應(yīng)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.
【作者單位】： 貴州省腫瘤醫(yī)院血液透析中心;
【基金】：貴州省科技廳科研基金[黔科合LG字(2016)7401號(hào)]
【分類號(hào)】：R653;R692

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