纳米碳示踪剂对老年甲状腺微小癌外科根治术的效果及预后的影响  

Effect of nano-carbon tracer on the outcome and prognosis of surgical resection of thyroid microcarcinoma in the aged

作　　者：龚勤俭 张莹华 杨再军 马洁[1] 李志辉[2] Gong Qinjian;Zhang Yinghua;Yang Zaijun;Ma Jie;Li Zhihui(Department of Breast and Thyroid Surgery,Anyue County People’s Hospital,Anyue 642300,China;West China Hospital,Sichuan University,Chengdu 610061,China)

机构地区：[1]资阳市安岳县人民医院乳腺甲状腺外科,四川安岳县642300 [2]四川大学华西医院,成都610061

出　　处：《中华普外科手术学杂志（电子版）》2020年第3期310-313,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：四川省卫生和计划委员会资助项目(17JP111)。

摘　　要：目的探讨纳米碳示踪剂对老年甲状腺微小癌(PTMC)手术的疗效和预后影响。方法回顾性分析2013至2017年间306例老年PTMC患者资料,根据是否使用纳米碳示踪剂将患者分为常规组(150例)和示踪组(156例),应用SPSS 17.0软件完成统计分析,术中术后指标、血钙和PTH水平以(±s)表示,采用独立t检验;术后并发症、术后1年复发率采用卡方检验;生存分析采用Kaplan-Meier法。以P<0.05差异有统计学意义。结果两组患者手术时间、术中出血量、术后引流量、术后住院时间差异均无统计学意义(P>0.05),但示踪组的淋巴结清扫数目和阳性淋巴结数目高于常规组(P<0.05);术后1 d、5 d和术后6个月示踪组PTH和血钙水平均高于常规组(P<0.05);示踪组的术后并发症肢体麻木、手足抽搐、肌肉痉挛、惊厥发作的发生率显著低于常规组(P<0.05);示踪组术后1年后复发率2.6%(4/156)明显低于常规组11.3%(17/150),差异有统计学意义(χ^2=9.678,P=0.022)。结论纳米碳示踪剂注射对甲状旁腺具有保护作用,可有效增加淋巴结的检出率,提高对患者预后质量,具有较高的临床意义。Objective To investigate the effect and prognosis of using nano-carbon tracer on thyroid microcarcinoma in the aged.Methods Data of 306 elderly PTMC patients from 2013 to 2017 were retrospectively analyzed.Patients were divided into the conventional group(150 cases)and the tracing group(156 cases)based on whether carbon nanoparticles were used or not.Statistical analysis was performed using SPSS 17.0 software.Intraoperative and postoperative indexes,serum calcium and PTH levels were expressed as(±s),and compared with independent t test;Postoperative complications and recurrence rates 1 year after surgery were compared by chi-square.Kaplan-Meier method was used for survival analysis.The difference was statistically significant with P<0.05.Results There was no significant difference between the two groups in operation time,intraoperative blood loss,postoperative drainage volume and postoperative hospital stay(P>0.05),but the number of lymph node dissection and positive lymph nodes in the tracing group were higher than those in the conventional group(P<0.05);the PTH and blood calcium levels in the tracer group were higher than those in the conventional group on the first day,the fifth day and the sixth month after operation(P<0.05).The incidence of limb numbness,extremities spasm and twitch,convulsion,muscle spasm and convulsion was significantly lower than that of the routine group(P<0.05).The recurrence rate of the tracing group was 2.6%(4/156)1 year after operation,which was significantly lower than that of the conventional group(11.3%,17/150).The difference was statistically significant(χ^2=9.678,P=0.022).Conclusion nano-carbon tracer injection has protective effect on parathyroid gland,which can effectively increase the detection rate of lymph nodes,improve the prognosis quality of patients,and has high clinical significance.

关 键 词：甲状腺肿瘤 癌 乳头状 纳米管 碳 预后 

分 类 号：R73[医药卫生—肿瘤]