纳米碳在腔镜甲状腺乳头状微小癌手术中的应用研究  

A preliminary study on clinical significance and method of using carbon nanoparticles in endoscopic treatment of papillary thyroid microcarcinoma

作　　者：饶尚锐 王中林 王毅 潘忠良 林哲 俞健 Rao Shangrui;Wang Zhonglin;Wang Yi;Pan Zhongliang;Lin Zhe;Yu Jian(Department of General Surgery,Wenzhou Central Hospital,Wenzhou 325000,China)

机构地区：[1]浙江省温州市中心医院普外科,温州325000

出　　处：《中华内分泌外科杂志》2018年第4期291-293,共3页Chinese Journal of Endocrine Surgery

基　　金：浙江省温州市科技计划项目（Y20160414）

摘　　要：目的初步探讨在腔镜甲状腺乳头状微小癌（papillary thyroid microcarcinoma，PTMC）手术中使用纳米碳悬液的价值及使用方法。方法74例拟行腔镜手术的PTMC患者根据随机数字表法分为实验组：术中使用纳米碳悬液者34例，对照组：未使用纳米碳悬液者40例，统计病理标本中癌灶大小、淋巴结检出情况、甲状旁腺损伤情况。结果74例均顺利完成手术，术后病理标本结果显示2组癌灶大小差异无统计学意义；对照组和实验组分别清扫出淋巴结177枚和220枚（其中淋巴结黑染率89%），实验组平均每例检出淋巴结（6.47±2.13）枚，明显多于对照组平均每例检出淋巴结（4.42±1.91）枚；对照组中甲状旁腺检出例数多于实验组（11例与3例），但差异无统计学意义；2组术后暂时性喉返神经损伤发生例数均为2例，2者差异无统计学意义。结论腔镜PTMC手术中使用纳米碳悬液同样能增加淋巴结检出率，并在一定程度上减少甲状旁腺的损伤，具有一定的临床推广意义，但使用时需注意避免污染腔镜视野。Objective To explore the value and method of using carbon nanoparticles in endoscopic treatment of papillary thyroid microcarcinoma. Method 74 cases were randomly divided into two groups, 34 cases in experimental group which were injected with carbon nanoparticles, and 40 cases in the control group without any injection. All cases were analyzed in terms of the tumor size, the number of lymph nodes and parathyroid gland injury. Results All patients underwent the operation smoothly. The postoperative pathological specimens result showed there was no statistical difference of carcinoma size between the two groups. The number of lymph nodes dissected was 177 in the control group and 220 in the experimental group （the rate of lymph node black staining rate was 89% ）. In the experimental group, the average number of lymph node detected in each patient was 6.47±2.13, more than 4.42±1.91 in the control group. The number of parathyroid glands found in the experimental group was 3 and 11 in the control group, and the difference had no statistical significance. Postoperative temporary laryngeal recurrent nerve injury occurred to 2 cases in each group, and no statistical difference was found. Conclusion Using carbon nanoparticles in endoscopic treatment of papillary thyroid microcarcinoma can increase the detection rate of lymph node, and to some extent, reduce the parathyroid injury. It has a certain clinical significance, However, care should be taken to avoid contamination of the mirror field of view.

关 键 词：腔镜 甲状腺乳头状微小癌 纳米碳悬液 淋巴结 甲状旁腺 

分 类 号：R736.1[医药卫生—肿瘤]