示踪用盐酸米托蒽醌在甲状腺乳头状癌术中应用研究OA北大核心CSTPCD

Objective To explore the difference in parathyroid protection and lymph node tracing effects between mitoxantrone hydrochloride and nanocarbon injection during papillary thyroid cancer(PTC)surgery,and to study the optimal time for mitoxantrone hydrochloride injection.Methods Prospectively analyze the clinical data of patients who underwent unilateral radical resection for thyroid cancer in the Thyroid Surgery Department of the Second Affiliated Hospital of Harbin Medical University from January 2023 to July 2023,observe the staining satisfaction,lymph node tracing effect,parathyroid gland identification,in-situ retention,miscutting,autologous transplantation,and recurrent laryngeal nerve injury after tracer gland injection and injection at different injection time points,operation duration and postoperative PTH and serum calcium status.Results Experiment 1:There was no significant difference in the staining satisfaction score of the mitoxantrone hydrochloride group compared with the nanocarbon group(P=0.341),the number of cases of membrane staining in the mitoxantrone group was significantly lower than that in the nanocarbon group(5 cases vs.13 cases)(P＜0.05),and the number of cases of tracheoesophageal groove staining in the mitoxantrone group(4 cases)was lower than that in the nanocarbon group(10 cases)(P=0.067).The intraoperative detection amount and in-situ retention amount of parathyroid glands in the mitoxantrone group(1.80±0.41),(1.66±0.48)and the nanocarbon group(1.73±0.45),(1.57±0.50)were significantly higher than those in the control group(1.37±0.49),(1.20±0.41),with statistical differences(P＜0.05).Experiment 2:The amount of parathyroid glands detected and retained in situ in the mitoxantrone injection group 2 hours before surgery and intraoperatively were(1.70±0.47),(1.57±0.50),(1.73±0.45),(1.60±0.50)respectively were significantly higher than those in the injection group 24 hours before surgery(1.37±0.49),(1.20±0.41),and the difference was statistically significant(P＜0.05).The operation time of the intraoperative injection group was(46.77±9.71)min,which showed an increasing trend compared with(42.10±1 1.03)min of the 2 h preoperative group and(41.73±10.42)min of the 24 h preoperative group(P=0.064,P=0.086).Conclusion Compared with nanocarbon,mitoxantrone hydrochloride has a better definition of the surgical area and has better potential to expose and protect the recurrent laryngeal nerve.The best time for tracer mitoxantrone hydrochloride injection is 2 hours before surgery.