纳米炭混悬液在甲状腺乳头状癌中央组淋巴结清扫中的应用  

Carbon nanoparticles suspension used in the central group lymph node dissection of papillary thyroid carcinoma

作　　者：许志亮[1] 王冠楠[1] 姚峰[1] 涂毅[1] 孙圣荣[1] 

机构地区：[1]武汉大学人民医院乳腺甲状腺外科,430060

出　　处：《中华实验外科杂志》2013年第10期2198-2200,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨甲状腺乳头状癌中央组淋巴结清扫术中使用纳米炭混悬液的意义.方法 甲状腺乳头状癌中央组淋巴结清扫术中使用纳米炭混悬液病例45例（淋巴结示踪组）,与同期术中未使用纳米炭混悬液病例49例（空白对照组）在清扫淋巴结数目、手术时间、术中出血量、术后引流量、甲状旁腺功能等方面进行比较.结果 淋巴结示踪组手术时间为（80.47±9.23） min、术中出血量为（35.53±7.43）ml、术后引流量为（71.09±12.18） ml;空白对照组手术时间为（84.65±12.01） min、术中出血量为（35.14±9.08） ml、术后引流量为（69.37±15.38） ml,两组比较差异无统计学意义（P＞0.05）；淋巴结示踪组术后低钙发生率（4.4％）低于空白对照组（20.4％,P＜0.05）；淋巴结示踪组术后1d甲状旁腺激素（PTH）水平[（35.36±18.35） ng/L]高于空白对照组[（26.58±15.80） ng/L,P＜0.05]、淋巴结示踪组术后1周PTH水平[（37.67±17.29） ng/L]高于空白对照组[（28.06±17.15） ng/L,P＜0.01]；淋巴结示踪组手术切除淋巴结的数目（9.40±2.35）枚多于空白对照组[（7.86±2.06）枚,P＜0.01].结论 术中使用纳米炭混悬液并未增加手术时间、术后引流量及术后并发症,提高了中央组淋巴结清扫的数目,同时有助于识别甲状旁腺并保护甲状旁腺功能.Objective To explore the clinical significance of carbon nanoparticles suspension used in the central group lymph node dissection of papillary thyroid carcinoma.Methods Forty-five patients with the central group lymph node dissection of papillary thyroid carcinoma were collected,and subjected to the injection of carbon nanoparticles suspension in the operation.Forty-nine cases at the same period without using carbon nanoparticles suspension in the operation served as blank control group.The number of dissected lymph nodes,operating time,operative blood loss,postoperative drainage volume,and parathyroid function were compared between two groups.Results The operating time was （80.47 ± 9.23） min,operative blood loss was （35.53 ±7.43） ml,and postoperative drainage volume was （71.09 ± 12.18） ml in experimental group,and those in blank control group were （84.65 ± 12.01） min,（35.14 ± 9.08） ml and （69.37 ± 15.38） ml respectively.There was no statistically significant difference between the two groups （P ＞ 0.05）.The incidence of postoperative hypocalcemia in experimental group （4.4％） was lower than in blank control group （20.4％） （P＜0.05）.The parathyroid hormone （PTH） level in experimental group on the first postoperative day [（35.36 ± 18.35） ng/L] was higher than in blank control group [（26.58 ± 15.80） ng/L] （P ＜0.05）.The PTH level in experimental group at the 7th postoperative day [（37.67 ± 17.29） ng/L] was higher than in blank control group [（28.06 ± 17.15） ng/L] （P ＜0.01）.The number of resected lymph nodes in experimental group （9.40 ± 2.35） was more than that in blank control group （7.86 ± 2.06） （P ＜ 0.01）.Conclusion Carbon nanoparticles suspension used in the central group lymph node dissection of papillary thyroid carcinoma is a kind of safe and reliable operation method which makes the procedure much more safer.

关 键 词：纳米炭混悬液 甲状腺癌 淋巴结清扫 甲状旁腺功能 

分 类 号：R736.1[医药卫生—肿瘤]