超声引导下纳米碳示踪在甲状腺微小癌切除术中应用研究  

Application of Ultrasound-guided Nano-cancer Tracer in Resection For Minimal Lesion of Thyroid Gland

作　　者：张勇豪 段晓刚 时贵阁 闫红印 王勇 Zhang Yonghao;Duan Xiaogang;Shi Guige;Yan Hongyin;Wang Yong(Pingmei Shenma Medical Group General Hospital,Pingdingshan,Henan 467000,China)

机构地区：[1]平煤神马医疗集团总医院,河南省平顶山市467000

出　　处：《中国超声医学杂志》2020年第10期865-868,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声引导下纳米碳示踪用于甲状腺微小癌切除术中病灶定位的价值。方法选择我院因甲状腺疾病手术治疗并经术后病理诊断确诊为甲状腺癌的120例患者,随机分为A、B、C组,全部患者均接受手术治疗,术前30 min A组患者在超声引导下于甲状腺病灶上下取2点并注射纳米碳混悬液注射液,B组注射亚甲蓝,C组直接经超声观察,并不向内注射示踪剂。调查记录并对比3组患者一般人口学资料,分析其可比性;对比3组手术相关情况,包括定位病灶直径、手术时间、淋巴结获得数、术中失血量及染色率;记录并对比3组患者术后出血、一过性低钙血症、一过性发音嘶哑等并发症发生情况。结果3组患者共检出淋巴结536枚,A组256枚、B组191枚、C组89枚;组间定位病灶直径比较差异无统计学意义(P>0.05);3组中,A组平均淋巴检出数最多、手术时间最短、术中失血量最少、淋巴结染色率最高,随后依次分别为B、C组,组间比较差异有统计学意义(P<0.05);组间术后出血、一过性发音嘶哑发生率比较差异无统计学意义(P>0.05);3组中C组一过性低钙血症发生率最高,其次为B、A组发生率最低,A、B两组比较差异无统计学意义(P>0.05);且均低于C组,组间比较差异有统计学意义(P<0.05)。结论超声引导下使用纳米碳示踪剂用于甲状腺微小病灶切除术前病灶定位,利于提高甲状腺癌术中淋巴结检出率及清扫率,患者手术时间缩短、术中失血量减少、术后低钙血症发生率降低,对甲状旁腺保护作用较亚甲蓝好。Objective To investigate the value of ultrasound-guided nano-carbon tracer in intraoperative lesion localization of minimal lesion resection of thyroid gland.Methods 120 patients with thyroid gland disease hospitalized from and diagnosed as thyroid cancer by postoperative pathological diagnosis were selected,and they were randomly divided into A group,B group and C group.All patients underwent surgery.Before surgery for 30 min,the upper and lower points of thyroid lesions in A group were taken under the guidance of ultrasound and injected with nano-carbon suspension injection,B group was injected with methylene blue,C group was directly observed by ultrasound and not injected with tracer agent.The general demographic data of three groups were compared,and the comparability was analyzed.The surgical conditions of three groups were compared,including the diameter of located lesion,operation time,number of lymph gland node,intraoperative bleeding volume and dyeing rate.The incidence of complications such as postoperative bleeding,transient hypocalcemia,transient phonetic hoarseness in three groups were compared.Results A total of 536 lymph gland nodes were detected in the three groups,including 256 nodes in A group,191 nodes in B group and 89 nodes in C group.There was no statistical difference in the diameter of located lesion among three groups(P>0.05).Among three groups,A group had the average highest number of lymph,shortest operation time,minimal intraoperative bleeding,highest dyeing rate of lymph gland node,followed by B group and C group(P<0.05).There was no statistical difference in the incidence of postoperative bleeding and transient phonetic hoarseness among three groups(P>0.05).The incidence of transient hypocalcemia in C group was the highest,followed by B group,and the incidence of A group was the lowest,and there was no statistical difference between A group and B group(P>0.05).A group and B group were lower than C group,and the difference was statistically significant(P<0.05).Conclusions Ultrasound-

关 键 词：甲状腺微癌 超声引导 纳米碳示踪 切除术 应用价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]