纳米碳在腔镜甲状腺癌手术中的应用

Application of carbon nanoparticle in endoscopic surgery of thyroid carcinoma

目的:探讨纳米碳在腔镜甲状腺癌根治术中的作用。方法:将43例甲状腺微小乳头状癌患者随机分为实验组与对照组,实验组于甲状腺内注射纳米碳混悬液,20 min后施术。统计清扫组织中淋巴结数量、转移淋巴结数量及甲状旁腺数量。结果:实验组平均清扫淋巴结(9.67±5.26)枚,对照组平均(4.95±2.54)枚,两组差异有统计学意义(t检验,t=3.716,P=0.001)。实验组于2例标本中找到甲状旁腺,对照组10例找到甲状旁腺,两组差异有统计学意义(χ2检验,χ2=6.894,P=0.009)。实验组淋巴结转移率为15.43%,对照组为8.16%,两组差异无统计学意义(t=1.043,P=0.303)。结论:纳米碳在腔镜甲状腺癌根治术中可使中央区淋巴结得到很好的显影,同时不会染黑甲状旁腺,术中清扫黑染组织,保留未黑染组织,可达到既彻底清扫淋巴结同时又保护甲状旁腺的效果。

Objective ： To explore the effect of carbon nanoparticle in endoscopic surgery of thyroid carcinoma. Methods ： Fortythree patients with papillary thyroid microcarcinoma were randomly divided into two groups ： the test group and control group. In the test group, emulsion of carbon nanoparticle was injected into thyroid gland 20 minutes before the operation. The number of lymph nodes, metastatic lymph nodes and parathyroid glands in speeimen were ealeulated. Results：The average number of lymph nodes was （9.67 ±5.26 ） and （4.95 ± 2.54） in the test group and control group respectively. The difference was statistically significant （ t test, t = 3.716, P =0. 001 ）. Parathyroid gland tissue was found in 2 specimens of the test group and 10 speeimens of the control group respectively.The difference was statistically significant （χ^2 test,χ^2= 6. 894, P = 0. 009）. The lymph node metastasis rates were 15.43% and 8.16% in the test group and control group respectively, and no statistical difference was observed （t = 1. 043, P = 0. 303 ）. Conelusions：Central compartment lymph node can be well stained black by using carbon nanoparticle injection in total endoscopic surgery of thyroid carcinoma. Parathyroid gland can be preserved by dissecting the black tissue and retaining the non-black tissue, and central compartment lymph node can be radically dissected at the same time.