纳米炭示踪剂联合直型双极电凝镊在甲状腺乳头状癌手术中的应用  

Study on the application of carbon nano-particle combined with bipolar electrocoagulation forceps in the surgery of papillary thyroid carcinoma

作　　者：王林[1] 欧亮[1] 赵志泓[1] WANG Lin;OU Liang;ZHAO Zhihong(Department of Thyroid and Breast Surgery,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212000,China)

机构地区：[1]江苏大学附属医院甲乳外科,江苏镇江212000

出　　处：《临床与病理杂志》2023年第10期1801-1808,共8页Journal of Clinical and Pathological Research

摘　　要：目的:比较纳米炭示踪剂联合使用双极电凝镊与超声刀在甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患者手术中的临床应用效果。方法:回顾性分析2019年1月至2022年11月在江苏大学附属医院实施开放性PTC手术的492例患者。所有患者均使用纳米炭示踪剂,根据术中所使用器械分成双极电凝镊组(n=301)与超声刀组(n=191)。比较2组患者的手术时间、术中出血量、术后第1天引流量、术后第2天引流量、术后并发症发生率(喉返神经损伤、甲状旁腺功能损伤)、住院时间、住院费用。结果:双极电凝镊组手术时间、术中出血量、术后第2天引流量、术后并发症发生率、住院时间以及住院费用均低于超声刀组,差异均有统计学意义(均P<0.05)。2组之间术后第1天引流量差异无统计学意义(P>0.05)。结论:临床中联合使用纳米炭示踪剂和双极电凝镊可以减少手术时间和术中出血,降低术后并发症的出现,缩短住院时间,减少住院费用。Objective:To compare the clinical application effects of carbon nano-particle combined with bipolar electrocoagulation forceps or harmonic scalpel in the surgery of papillary thyroid carcinoma(PTC).Methods:A retrospective analysis was conducted on 492 patients who underwent open surgery for PTC surgery at Affiliated Hospital of Jiangsu University from January 2019 to November 2022.All patients were treated with nanocarbon tracers and divided into a bipolar electrocoagulation forceps group(n=301)and a harmonic scalpel group(n=191)based on the instruments used during surgery.The surgical time,intraoperative bleeding volume,drainage volume on the first and second day after surgery,incidence of postoperative complications(recurrent laryngeal nerve injury,parathyroid function injury),length of hospital stay,and hospitalization costs were compared between the 2 groups.Results:Compared with the ultrasound knife group,the surgical time,intraoperative bleeding volume,incidence of postoperative complications,drainage volume on the second day,length of hospital stay,and hospitalization costs in the bipolar electrocoagulation group were significantly lower(all P<0.05).There was no significant difference in drainage volume on the first day after surgery between the 2 groups(P>0.05).Conclusion:The combined use of carbon nano-particle and bipolar electrocoagulation forceps in clinical practice can reduce surgical time and intraoperative bleeding,decrease the incidence of postoperative complications,shorten hospital stay,and reduce hospitalization costs.

关 键 词：甲状腺乳头状癌 双极电凝镊 超声刀 纳米炭示踪剂 术后并发症 

分 类 号：R736.1[医药卫生—肿瘤]