临床普外科电子杂志 ›› 2025, Vol. 13 ›› Issue (4): 25-.

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吲哚菁绿在甲状腺癌手术中的临床应用分析

  

  1. 东台市人民医院 普通外科,江苏 盐城 224000
  • 出版日期:2025-10-01 发布日期:2026-01-29
  • 基金资助:

    2022年度南通大学临床医学专项项目(2022LQ002)

Clinical application of indocyanine green in thyroid cancer surgery

  1. General Surgery Department of Dongtai People's Hospital, Jiangsu Yancheng 224000, China
  • Online:2025-10-01 Published:2026-01-29

摘要:

目的 探讨在甲状腺癌手术中使用吲哚菁绿的临床价值。方法 选取东台市人民医院 2023 年 1 月至 2024 年 3 月收治的甲状腺微小乳头状癌患者 92 例,按随机数字表法分为观察组(n=46)、对照组(n=46)。所有患者均接受单侧甲状腺癌根治术(单侧甲状腺叶及峡部切除术 + 同侧颈中央区淋巴结清扫术)。对照组实施常规甲状腺癌根治术治疗,观察组行吲哚菁绿引导的甲状腺癌根治术治疗。比较两组围手术期指标、血钙及甲状旁腺激素水平,以及并发症发生情况。结果 术前,两组患者的血钙及甲状旁腺激素水平比较无显著差异(P > 0.05);术后 1d,两组患者血钙和甲状旁腺激素水平均低于术前,且观察组较对照组高,差异均有显著性(P < 0.001)。观察组患者的淋巴结清扫数量较对照组多,术中出血量较对照组少,差异均有显著性(P < 0.001);两组患者的手术时间比较无显著差异(P > 0.05)。观察组喉返神经损伤、甲状旁腺误切发生率分别为 0、4.35%(2/46),均低于对照组 [ 分别为 13.04%(6/46)、17.39%(8/46)],差异均有显著性(P 分别为 0.026、0.045)。结论 吲哚菁绿引导的甲状腺癌根治术能够提高淋巴结清扫数量,减少对正常组织造成的损伤,降低喉返神经损伤和甲状旁腺误切发生率。

关键词: 吲哚菁绿, 甲状腺癌根治术, 甲状旁腺激素, 血钙, 并发症

Abstract:

Objective To explore the clinical value of using indocyanine green (ICG) in thyroid cancer surgery. Method 92 patients with papillary thyroid microcarcinoma treated in Dongtai people's Hospital from January 2023 to March 2024 were selected and randomly divided into observation group (n=46) and control group (n=46). All patients underwent unilateral radical thyroidectomy (unilateral thyroidectomy and isthmus resection + ipsilateral central neck lymph node dissection). The control group was treated with conventional radical thyroidectomy, and the observation group was treated with indocyanine green guided radical thyroidectomy. The perioperative indicators, serum calcium and parathyroid hormone levels, and the incidence of complications were compared between the two groups. Result Before operation, there was no significant difference in serum calcium and parathyroid hormone levels between the two groups(P > 0.05); One day after operation, the blood calcium and parathyroid hormone levels of the two groups were lower than those before operation, and the observation group was higher than that of the control group, with significant differences(P < 0.001). The number of lymph node dissection in the observation group was more than that in the control group, and the intraoperative blood loss was less than that in the control group, with significant differences(P < 0.001); There was no significant difference in operation time between the two groups(P > 0.05). The incidences of recurrent laryngeal nerve injury and parathyroid gland MIS resection in the observation group were 0 and 4.35%(2/46), respectively, which were lower than those in the control group [13.04%(6/46) and 17.39%(8/46), respectively], and the differences were significant (P=0.026 and 0.045, respectively). Conclusion Radical thyroid cancer treatment under ICG guidance can increase the number of lymph node dissections, reduce the damage to normal tissues, and reduce the incidence of recurrent laryngeal nerve damage and parathyroid misresection.

Key words: Indocyanine green, Radical thyroid cancer surgery, Parathyroid hormone, Blood calcium, Complications