Clinical Application of Near Infrared Fluorescence Imaging Combined with Nano Carbon Injection in The Protection of Parathyroid Function during Total Thyroidectomy

ZHAI Baowei; ZHU Xin; CHEN Xinyue

doi:10.14033/j.cnki.cfmr.2025.21.013

Abstract：Objective:To investigate the clinical effect of near infrared autofluorescence imaging(NIFI)combined with nano-carbon(CNP)in the protection of parathyroid function during total thyroidectomy.Method:A total of 300 patients who planned to undergo elective total thyroidectomy in the Department of Vascular and Thyroid Surgery of Guizhou People's Hospital from January to December 2024 were selected as the study objects,and were divided into three groups by random number table,including routine operation group,nano carbon group and combined treatment group,each with 100 cases.The parathyroid gland was identified by gross observation in the conventional operation group,CNP injection negative imaging was used in the nano carbon group,and NIFI combined with CNP injection was used in the combined treatment group.Treatment parameters,calcium and phosphorus metabolism and parathyroid indexes of the three groups were compared before and 1 day after surgery,and parathyroid identification accuracy and parathyroid injury were calculated.Result:The doses of alfacalcalcitol and calcium carbonate in combined treatment group were lower than those in conventional operation group and nano carbon group,while those in nano carbon group were lower than those in conventional operation group,the differences were statistically significant(P<0.05).After operation,the levels of parathyroid hormone(PTH),serum calcium and phosphorus in the three groups were decreased compared with those before operation,and the decrease of these indexes in the combined treatment group was smaller than that in the conventional surgery group and the nano carbon group,the nano carbon group was smaller than that in the conventional surgery group,the differences were statistically significant(P<0.05).The accuracy of parathyroid identification in the combined treatment group was higher than that in the conventional operation group,the nano carbon group,and the nano carbon group was higher than that in the conventional operation group,the differences were statistically significant(P<0.05).The incidence rate of hypoparathyroidism(HP)in combined treatment group was lower than those in conventional surgery group and nano carbon group,those in nano carbon group were lower than those in conventional surgery group,the differences were statistically significant(P<0.05).Conclusion:In total thyroidectomy,NIFI combined with CNP can effectively improve the accuracy of parathyroid identification,reduce the incidence of HP and the rate of parathyroid misresection and transplantation,improve calcium and phosphorus metabolism and thyroid function,and reduce the dosage of hypocalcemia related drugs.