纳米活性炭在基层医院甲状腺手术中的应用价值探讨  

Application Value of Activated Carbon Nanoparticles in Thyroid Surgery in Primary Hospitals

作　　者：董秀志 王俊 陆佳伟 肖磊 DONG Xiu-zhi;WANG Jun;LU Jia-wei;XIAO Lei(Department of General Surgery,The First People’s Hospital of Pinghu City,Pinhu,Zhejiang 314200,China)

机构地区：[1]平湖市第一人民医院外二科,浙江平湖314200

出　　处：《河北北方学院学报（自然科学版）》2021年第2期9-12,18,共5页Journal of Hebei North University:Natural Science Edition

基　　金：平湖市科技局[2019]29号社发类项目(No.24)。

摘　　要：目的探讨纳米活性碳(activated carbon nanoparticles,ACNP)在基层医院甲状腺手术中的应用价值。方法选择行手术治疗的113例甲状腺结节患者为研究对象,其中38例术中注射ACNP混悬液为观察组,另外75例未注射ACNP者为对照组,术前、术后第1、3天检测患者血钙水平,比较2组患者术后甲状旁腺误切除率、低钙血症/酸麻/抽搐及声音嘶哑发生率。结果观察组术后发生低钙血症/酸麻/抽搐5例、病理证实甲状旁腺误切1例、声音嘶哑1例,对照组分别发生10例、10例、2例,差异均无统计学意义(P>0.05)。但进一步分层统计后结果显示,甲状腺恶性肿瘤观察组术后未出现甲状旁腺误切,对照组出现7例,差异有统计学意义(P<0.05)。结论基层医院甲状腺手术中使用ACNP有助于减少甲状旁腺损伤,但对甲状腺良性肿瘤患者应用价值不大,同时对喉返神经的保护意义待进一步明确。Objective To investigate the application value of activated carbon nanoparticles(ACNP)in thyroid surgery in primary hospitals.Methods 113 patients with thyroid nodules who underwent surgical treatment were selected as the research objects.Among them,38 cases injected with ACNP suspension during operation were enrolled into observation group,and 75 cases without ACNP injection into control group.Serum calcium level was detected before operation and on the first and third day after operation.The incidences of parathyroidectomy by mistake,hypocalcemia,numbness,convulsion and hoarseness were compared between the two groups.Results In the observation group,there were 5 cases of hypocalcemia/numbness/convulsion,1 case of parathyroidectomy by mistake confirmed by pathology,and 1 case of hoarseness in the observation group.The corresponding number of cases in the control group were 10,10 and 2,respectively,and the differences were of no statistical significance(P>0.05).However,further stratified statistics showed that there was no parathyroid miscarriage in the observation group and 7 cases in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of ACNP in thyroid surgery in primary hospital is helpful to reduce parathyroid injury,but it has little value in the operation of thyroid benign tumor.At the same time,the protection of recurrent laryngeal nerve needs to be further clarified.

关 键 词：纳米活性碳 甲状腺手术 甲状旁腺 喉返神经 

分 类 号：R653[医药卫生—外科学]