甲状腺乳头状癌术中纳米炭示踪对淋巴结清扫及甲状旁腺保护的临床意义  

Clinical significance of carbon nanoparticles tracing in lymph node dissection and parathyroid gland protection in papillary thyroid carcinoma surgery

作　　者：南润玲[1] 尚培中[1] 王金[1] 张克俭 王铁山[1] 聂阿娜 李艳艳[1] 张伟[1] 胡玮[1] 

机构地区：[1]解放军第251医院普通外科,张家口075000

出　　处：《中华普通外科学文献（电子版）》2018年第1期36-39,共4页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探讨甲状腺乳头状癌术中纳米炭混悬注射液淋巴示踪对淋巴结清扫及甲状旁腺保护的临床意义。方法回顾性分析解放军第251医院2014年5月至2016年12月收治80例甲状腺乳头状癌患者临床资料,将40例注射纳米炭混悬注射液的患者作为研究组,40例常规手术患者作为对照组。比较两组淋巴结检出数目及甲状旁腺的损伤情况。结果(1)淋巴结总数:研究组438枚,平均(9.4±2.3)枚/例;对照组332枚,平均(5.7±1.7)枚/例;(2)微淋巴结检出数:研究组102枚,平均(3.3±2.3)枚/例,对照组40枚,平均(1.5±1.1)枚/例;(3)转移淋巴结数:研究组290枚,平均(7.2±2.6)枚/例;对照组155枚,平均(3.8±1.7)枚/例;上述三组数据两组间对比差异均有统计学意义(t=6.59、4.89、13.28,P=0.01、0.02、0.00);(4)术后病理标本中甲状旁腺组织检出率:研究组为5.0%(2/40),明显低于对照组的22.5%(9/40),差异有统计学意义(χ~2=7.04,P=0.00)。结论甲状腺乳头状癌根治术中通过纳米炭混悬注射液对颈部淋巴通路进行标记及定位,可有效提高淋巴结的检获数,增强手术的精准性和彻底性。同时,通过其负显影作用有助于减少甲状旁腺损伤。Objective To investigate the clinical significance of carbon nanoparticles suspension injection tracing in lymph node dissection and parathyroid gland protection in papillary thyroid carcinoma surgery.Methods The clinical data of eighty cases with papillary thyroid carcinoma in the 251 st Hospital of PLA from May 2014 to December 2016 were retrospectively analyzed,forty patients with carbon nanoparticles suspension injection regarded as the study group,and forty with conventional operation regarded as the control group.The number of lymph nodes and postoperative pathology specimens with or without parathyroid glands tissue were compared between the two groups.Results（1） Total number of lymph nodes：in study group 438 lymph nodes were detected,with an average of（9.4±2.3） per case and in control group there were 332,with an average of（5.7±1.7） per case.（2） Tiny lymph nodes：102 tiny lymph nodes were found in study group,with an average of（3.3±2.3） per case and in control group there were 40,with an average of（1.5±1.1） per case.（3） Metastatic lymph nodes：in study group 290 metastatic lymph nodes were detected,with an average of（7.2±2.6） per case and in control group there were 155,with an average of（3.8±1.7） per case.The differences between the two groups were statistically significant（t=6.59,4.89,13.28,P=0.01,0.02,0.00）.（4） The detection rate of parathyroid glands in postoperative pathological specimens：the incidence of parathyroid glands in postoperative pathological specimens was 5.0%（2/40） in study group and 22.5%（9/40） in control group,the difference was statistically significant（χ^2=7.04,P=0.00）.Conclusions In papillary thyroid carcinoma surgery,the lymph marking and locating with carbon nanoparticles suspension injection can increase the rate of detected neck lymph nodes,enhance the accuracy and thoroughness of operation.Meanwhile,it can reduce the damage of parathyroid gland by negative development.

关 键 词：甲状腺肿瘤 癌 乳头状 纳米管 碳 甲状旁腺 

分 类 号：R736.1[医药卫生—肿瘤]