甲状腺癌术中淋巴示踪剂应用对于甲状旁腺保护作用的研究  

Protective effect of lymphatic tracer on parathyroid glands in lymph node dissection in thyroid carcinoma

作　　者：曾玉剑[1] 钱军[1] 程若川[1] 马云海[1] 刘霜[2] 

机构地区：[1]昆明医学院第一附属医院胃肠与甲状腺外科,昆明650032 [2]昆明医学院第一附属医院干部医疗科超声室,昆明650032

出　　处：《重庆医学》2012年第11期1076-1076,1088,共2页Chongqing medicine

摘　　要：目的研究纳米炭淋巴示踪剂的应用在甲状腺癌淋巴结清扫时对于甲状旁腺的保护价值。方法 80例甲状腺癌患者随机平均分为常规组和纳米炭组,比较两组中央区淋巴结脂肪组织中误切的甲状旁腺检获情况及术后血钙、甲状旁腺素(PTH)改变的情况。结果 80例患者全部由同组手术者施行甲状腺全切和中央区淋巴结清扫术或甲状腺全切和改良式颈部淋巴结清扫术;其中常规组误切甲状旁腺11枚,纳米炭组没有甲状旁腺误切。两组都没有永久性低钙血症及PTH降低。一过性低钙血症症状发生常规组为14例,纳米炭组为1例。PTH暂时性减低的发生常规组为18例,纳米炭组为3例。结论甲状腺和甲状旁腺的淋巴引流无交通现象。纳米炭的应用有助于将甲状旁腺组织与甲状腺组织及淋巴脂肪组织区分开来,极大地降低了甲状腺癌淋巴清扫术中甲状旁腺的损伤概率。Objective To evaluate the protective effect of lymphatic tracer on parathyroid glands in lymph node dissection in thyroid carcinoma.Methods Eighty patients with thyroid carcinoma were randomly divided into the routine method group and carbon nanoparticle group.Parathyroid glands in adipose tissue dissected,blood calcium,and PTH of two groups were contrasted and analyzed.Results All 80 cases underwent total thyroidectomy and lymph node dissection performed by a same team.11 parathyroid glands were examined in routine method group,while none in carbon nanoparticle group.None permanent hypocalcemia and PTH were observed in both groups.There were 14 cases with temple hypocalcemia and 18 cases with temple PTH decrease respectively in routine method group,and there were 1 and 3 cases respectively in carbon nanoparticle group.Conclusion There is no lymph communication between thyroid gland and parathyroid gland.Application of nanoparticle in lymph node dissection in thyroid carcinoma can separate parathyroid glands from thyroid tissue and fatty tissue,decreasing the probability of parathyroid gland damaged.

关 键 词：甲状旁腺 保护 纳米炭 淋巴结切除术 

分 类 号：R736.1[医药卫生—肿瘤]