研究免疫胶体金法（ICGT）、近红外自体荧光显像技术（NIRAF）和肉眼辨认法在术中识别与保护甲状旁腺的临床应用效果。

选择2020年2月~2021年12月在合肥市第二人民医院接受甲状腺手术治疗的227例患者，根据术中选择不同的甲状旁腺识别方式，可分为3组：肉眼辨认组73例、NIRAF组76例和ICGT组78例。比较3组在术中甲状旁腺识别效果的差异性、甲状旁腺激素（PTH）及血钙水平的变化趋势、术后相关并发症的发生情况。

在肉眼辨认组中，73例患者术中共采集106份可疑甲状旁腺组织样本。该方法对甲状旁腺的识别特异度为44%，敏感度为82.7%，误诊率为56%，准确率为73.6%。在NIRAF组中，共对76例患者术中采集可疑甲状旁腺组织样本118份。该技术对甲状旁腺的识别特异度为83.9%，敏感度为95.4%，误诊率为16.1%，准确率为92.4%。ICGT组共纳入78例患者，术中采集可疑甲状旁腺组织样本133份，识别甲状旁腺的特异度为95.2%、敏感度为92.3%，误诊率为4.8%，准确率为93.2%。与肉眼辨认法及NIRAF技术相比，ICGT在特异度和准确率方面具有更明显的优势。3组患者于术前及术后第6个月的PTH与血钙水平比较差异均无统计学意义（P>0.05），而在术后第3 d、第5 d、第1个月和第3个月，ICGT组与NIRAF组的PTH及血钙水平显著高于肉眼辨认组（P<0.05），但两者之间差异无统计学意义（P>0.05）。术后低钙血症的发生率在肉眼辨认组为24.7%，在NIRAF组为10.5%，在ICGT组为7.7%，肉眼辨认组术后低钙血症发生率明显高于其他2组（P<0.05）。术后永久性甲状旁腺功能减退的发生率在肉眼辨认组为2.7%，NIRAF组为0，ICGT组为0，3组间差异无统计学意义（P>0.05）。

ICGT在甲状腺切除术中对甲状旁腺的识别具有较高的特异度和准确率，能够有效减少术后并发症的发生率，尤其在保护甲状旁腺功能方面表现出较高的临床价值。

To evaluate the clinical efficacy of the immunocolloidal gold technique (ICGT), near-infrared autofluorescence imaging (NIRAF), and visual recognition in the intraoperative identification and preservation of parathyroid glands (PTGs).

A total of 227 patients undergoing thyroid surgery at Hefei Second People's Hospital from February 2020 to December 2021 were enrolled and divided into three groups based on the parathyroid identification method used: visual recognition group (n=73), NIRAF group (n=76), and ICGT group (n=78). The differences in intraoperative PTG identification, trends in parathyroid hormone (PTH) and serum calcium levels, and postoperative complications were compared among the groups.

In the visual recognition group, 106 suspected PTG samples were collected from 73 patients. The method demonstrated a specificity of 44%, sensitivity of 82.7%, misdiagnosis rate of 56%, and accuracy of 73.6%. In the NIRAF group, 118 samples were obtained from 76 patients, with a specificity of 83.9%, sensitivity of 95.4%, misdiagnosis rate of 16.1%, and accuracy of 92.4%. In the ICGT group, 133 samples were collected from 78 patients, with a specificity of 95.2%, sensitivity of 92.3%, misdiagnosis rate of 4.8%, and accuracy of 93.2%. Compared with visual recognition and NIRAF, ICGT demonstrated superior specificity and accuracy. No significant differences in PTH and serum calcium levels were observed among the three groups preoperatively or at 6 months postoperatively (P>0.05). However, at postoperative days 3 and 5, and at 1 and 3 months, both the ICGT and NIRAF groups exhibited significantly higher PTH and calcium levels than the visual recognition group (P<0.05), though there was no significant difference between ICGT and NIRAF (P>0.05). The incidence of postoperative hypocalcemia was 24.7% in the visual recognition group, 10.5% in the NIRAF group, and 7.7% in the ICGT group, with the visual group showing a significantly higher rate (P<0.05). The incidence of permanent hypoparathyroidism was 2.7% in the visual group, 0 in the NIRAF group, and 0 in the ICGT group, with no significant intergroup difference (P>0.05).

ICGT demonstrates high specificity and accuracy in identifying PTGs during thyroidectomy, effectively reducing postoperative complications and showing strong clinical value in preserving parathyroid function.