将非热等离子体整合到甲状腺切除术手术流程中：关于术后早期安全性和组织恢复的前瞻性初步研究
Integration of Non-Thermal Plasma into the Thyroidectomy Surgical Workflow: A Prospective Pilot Study on Early Postoperative Safety and Tissue Recovery.
文献信息
| PMID | 42940107 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | César Jaramillo-Martínez |
| 作者单位 | Instituto de Seguridad Social del Estado de México y Municipios (ISSEMYM) Medical Centre Toluca, Av. Baja velocidad 284 km. 57.5, San Jerónimo Chicahualco, Metepec 52170, Estado de México, Mexico. |
| 期刊 | Biomedicines |
| SCI 分区 | Q2 |
| IF | 4.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 甲状腺切除术是甲状腺疾病治疗的基石，但存在喉返神经损伤、甲状旁腺功能减退和颈部血肿等风险。非热等离子体（NTP）可能改善局部止血和组织愈合，但其在颈部神经血管轴内的安全性需要人体验证。
方法： 这项前瞻性、干预性、单臂初步研究评估了将大气压NTP（0.5 W/cm2）整合到30例患者标准甲状腺切除术流程中的可行性、可重复性和术后早期安全性。安全性终点包括无热损伤、神经血管并发症或手术部位并发症。我们使用温哥华瘢痕量表（VSS）和患者与观察者瘢痕评估量表（POSAS）评估愈合和美学结局。
结果： NTP整合实现了100%的技术可行性，无反应器故障、气体输送中断或热异常。未发生重大急性并发症，包括阻塞性血肿、喉返神经损伤或严重术后低钙血症（0/30；0.0%）。早期切口评估显示良好评分（VSS中位数：1.2，IQR：1.0-2.0；POSAS总体意见中位数：1.1，IQR：1.0-1.5），在术后14天里程碑进行描述性报告。术中生物物理评估和术后临床追踪未显示明显热异常或深部结构改变，支持高生物安全性。
结论： 将NTP整合到内分泌颈部手术流程中显示出技术可行性、后勤效率和良好的术后早期安全性特征。该干预与良好的早期切口愈合特征相关，且未损害邻近重要结构。这些初步发现支持NTP作为一种可重复、可靠的手术辅助手段，并为内分泌外科实践提供了坚实的临床和方法学基础。
英文摘要
Background: Thyroidectomy is a cornerstone treatment for thyroid pathologies but carries risks including recurrent laryngeal nerve injury, hypoparathyroidism, and cervical haematomas. Non-thermal plasma (NTP) may improve local haemostasis and tissue healing, although its safety within the cervical neurovascular axis requires human validation. Methods: This prospective, interventional, single-arm pilot study evaluated the feasibility, reproducibility and early postoperative safety of integrating atmospheric-pressure NTP (0.5 W/cm2) into the standard thyroidectomy workflow in 30 patients. Safety endpoints included the absence of thermal injury, neurovascular complications, or surgical-site morbidity. We assessed healing and aesthetic outcomes using the Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS). Results: NTP integration achieved 100% technical feasibility, without reactor failures, gas-delivery interruptions, or thermal anomalies. No major acute complications occurred, including obstructive haematomas, recurrent laryngeal nerve injuries, or severe postoperative hypocalcaemia (0/30; 0.0%). Early incisional assessments showed favourable scores (median VSS: 1.2, IQR: 1.0-2.0; median POSAS overall opinion: 1.1, IQR: 1.0-1.5), reported descriptively at the 14-day postoperative milestone. Intraoperative biophysical evaluations and postoperative clinical tracking revealed no overt thermal anomalies or deep structural alterations, supporting high biological safety. Conclusions: Integration of NTP into the endocrine neck surgery workflow demonstrates technical feasibility, logistical efficiency, and a favourable early postoperative safety profile. The intervention is associated with a favourable early incisional healing profile without compromising adjacent vital structures. These preliminary findings support NTP as a reproducible, reliable surgical adjunct and provide a robust clinical and methodological basis for endocrine surgical practice.