纳米碳在cN0期甲状腺乳头状微小癌Ⅵ区淋巴结清扫术中的应用  

Clinical observation: Nanocarbon in Ⅵ regional lymph node dissection of cN0 thyroid papillary micro-carcinoma

作　　者：徐莹颖 虞同华[2] 李超 王磊 蒋媛[2] 戚庭月 施燕芸 XU Ying-ying1,YU Tong-hua2,LI Cha3,WANG Lei4,JIANG-yuan2,QI Ting-yue5,SHI Yan-yun5(1.Department of General Surgery;3.Department of Gardiology;4.Department of Pathology;5.Department of Ultrasound,YiZheng People＇s Hospital Affiliated to Yangzhou University,Yizheng 211400,China;2.Department of Pathology,YiZheng People＇s Hospital Affiliated to Yangzhou University,Yangzhou 200000,Chin)

机构地区：[1]扬州大学附属仪征市人民医院普外科,江苏仪征211400 [2]江苏省肿瘤医院头颈外科,江苏南京210000 [3]扬州大学附属仪征市人民医院心内科,江苏仪征211400 [4]扬州大学附属仪征市人民医院病理科,江苏仪征211400 [5]扬州大学附属仪征市人民医院超声科,江苏仪征211400

出　　处：《中国现代普通外科进展》2018年第6期425-428,共4页Chinese Journal of Current Advances in General Surgery

基　　金：江苏省扬州市科技局社会发展面上项目(YZ2017085)

摘　　要：目的 :探讨纳米碳在cN0期甲状腺乳头状微小癌Ⅵ区淋巴结清扫术中的应用价值。方法 :选择2017年1~11月cN0期甲状腺乳头状微小癌患者69例,在患者知情同意的情况下,分为对照组(n=33例)和观察组(n=36例)。对照组采取常规Ⅵ区淋巴结清扫术,观察组采取注射纳米碳后Ⅵ区淋巴结清扫术,比较两组患者术中术后情况及淋巴结检出率、甲状旁腺误切率。结果:两组患者手术时间、术中出血量比较差异均无统计学意义(P>0.05);观察组术后第1天血清钙水平、血清PTH水平显著高于对照组(P<0.05);观察组淋巴结检出个数与阳性淋巴结检出个数均显著多于对照组(P<0.05),而甲状旁腺误切例数与临床诊断喉返神经损伤例数均显著少于对照组(P<0.05)。结论:在cN0期甲状腺乳头状微小癌患者行Ⅵ区淋巴结清扫过程中,应积极辅以纳米碳显影,可显著提高阳性淋巴结的检出率,降低甲状旁腺误切与喉返神经损伤,促进患者的术后康复。Objective： To explore the value of Nanocarbon in Ⅵ regional lymph node dissection of cN0 thyroid papillary micro-carcinoma. Method： Collect 69 cN0 thyroid papillary micro-carcinoma patients from January to November in 2017, they were divided into control group（n=33） and observation group（n=36） under the condition of informed consent. In the control group, conventional Ⅵlymph node dissection was performed. In the observation group, the Ⅵ lymph node dissection was performed after the injection of Nanocarbon. The postoperative condition, lymph node detection rate and parathyroid malocclusion rate were compared between the two groups. Result： There was no significant difference between the two groups in operation time and intraoperative blood loss（P 〉0.05）. The level of serum calcium and serum PTH in the observation group were significantly higher than those in the control group on the first day after operation（P 〈0.05）. The number of detected lymph nodes and the number of positive lymph nodes detected in the observation group were significantly more than those in the control group（P 〈0.05）, while the number of parathyroid glands and the number of recurrent laryngeal nerve lesions in clinical diagnosis were significantly less than those in the control group（P 〈0.05）. Conclusion： In cN0 thyroid papillary micro-carcinoma patients with Ⅵarea lymph node dissection,it should be actively supplemented with Nanocarbon imaging, it could significantly increase the positive lymph node detection rate, reduce parathyroid misdiagnosis and recurrent laryngeal nerve injury and promote patients’ postoperative recovery.

关 键 词：甲状腺乳头状微小癌 纳米碳 Ⅵ区淋巴结清扫术 淋巴结 

分 类 号：R736.1[医药卫生—肿瘤]