甲状腺癌手术中应用纳米碳负显影技术对甲状旁腺的保护作用  

Protective effect of carbon nanonegative imaging on parathyroid gland during thyroid cancer surgery

作　　者：施杲旸 王莹[1] 陆辉[1] 杭菁[2] 辅容 SHI Gao-yang;WANG Ying;LU Hui(Department of General Surgery,The First Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 210029,China)

机构地区：[1]南京医科大学第一附属医院普外科,江苏南京210029 [2]南京医科大学第一附属医院超声医学科,江苏南京210029

出　　处：《临床和实验医学杂志》2024年第2期180-183,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省卫健委医学科研面上项目(编号:M2022027);中国博士后科学基因科研项目(编号:2021M701493)。

摘　　要：目的观察甲状腺癌手术中应用纳米碳负显影技术对甲状旁腺的保护作用。方法回顾性分析2020年6月至2022年6月南京医科大学第一附属医院收治的100例甲状腺癌根治术患者的临床资料。按照治疗方法不同分为观察组(n=50)和对照组(n=50)。两组均采用甲状腺癌根治术治疗,观察组术中通过纳米碳负显影技术保护甲状旁腺,对照组术中根据经验避免甲状旁腺损伤。比较两组患者的手术时间、术中出血量、术后住院时间,收集两组患者术前和术后血清钙离子和甲状旁腺激素(PTH)水平,并比较两组患者的淋巴结清除数目、淋巴结转移率以及喉返神经损伤、甲状旁腺损伤/误切发生率、复发率和转移率。结果观察组患者的平均手术时间为(130.96±20.64)min,明显短于对照组[(162.40±14.21)min],差异有统计学意义(P<0.05);两组患者的术中出血量和术后住院时间比较,差异均无统计学意义(P>0.05)。术后,观察组患者血清钙和PTH水平分别为(2.31±0.10)mmol/L、(21.55±5.33)pg/mL,均显著高于对照组[(2.03±0.11)mmol/L,(13.55±4.63)pg/mL],差异均有统计学意义(P<0.05)。观察组患者的淋巴结清除数目为(7.96±1.44)个,多于对照组[(6.52±1.32)个],差异有统计学意义(P<0.05),但两组患者在淋巴结转移率方面差异无统计学意义(P>0.05)。观察组患者的喉返神经损伤和甲状旁腺损伤/误切发生率为4.00%和2.00%,显著低于对照组(20.00%、22.00%),差异有统计学意义(P<0.05)。观察组患者的复发率为4.00%,显著低于对照组(26.00%),差异有统计学意义(P<0.05);而转移率比较差异无统计学意义(P>0.05)。结论甲状腺癌手术中应用纳米碳技术能够缩短手术时间,对维持血清钙和PTH水平稳定具有一定优势,并降低喉返神经损伤和甲状旁腺损伤/误切的发生率,同时降低复发率,显示出一定的优势和对甲状旁腺的保护作用。Objective To observe the protective effect of carbon nanonegative imaging on parathyroid gland during thyroid cancer surgery.Methods The clinical data of 100 patients with radical thyroidectomy treated in the First Affiliated Hospital of Nanjing Medical University from June 2021 to June 2023 were retrospectively selected.They were divided into observation group(n=50)and control group(n=50)according to different treatment methods.Both groups were treated with radical thyroidectomy,the observation group was treated with nano carbon negative imaging to protect parathyroid,and the control group was treated with experience to avoid parathyroid injury.The operation time,intraoperative blood loss,postoperative hospital stay were compared between the two groups.The levels of serum calcium ion and parathyroid hormone(PTH)were collected before and after surgery in the two groups.And the number of lymph node clearance,lymph node metastasis rate,recurrent nerve injury,parathyroid injury/misincision rate,recurrence rate and metastasis rate were compared between the two groups.Results The operation time of the observation group was(130.96±20.64)min,which was significantly less than that of the control group[(162.40±14.21)min],and the difference was statistically significant(P<0.05);there were no statistically significant differences in intraoperative blood loss and postoperative hospital stay between the two groups(P>0.05).After operation,the levels of serum calcium and PTH in the observation group were(2.31±0.10)mmol/L and(21.55±5.33)pg/mL,which were significantly higher than those in the control group[(2.03±0.11)mmol/L,(13.55±4.63)pg/mL],and the differences were statistically significant(P<0.05).The number of lymph node clearance in the observation group was(7.96±1.44)pieces,significantly higher than that in the control group[(6.52±1.32)pieces],and the difference was statistically significant(P<0.05);but there was no statistically significant difference in lymph node metastasis rate between the two groups(P>0.05).The

关 键 词：甲状腺癌 纳米碳负显影 甲状旁腺 甲状旁腺激素 

分 类 号：R736.1[医药卫生—肿瘤]