纳米碳在甲状腺癌手术中对甲状旁腺保护作用的研究

Carbon nanoparticles in protection of parathyroid glands in operation for thyroid carcinoma

目的研究纳米碳混悬注射液在甲状腺癌手术中保护甲状旁腺的作用。方法选取2013年3月至2015年3月在本院首次实施甲状腺癌手术的患者，将患者随机分为纳米碳组和对照组。纳米碳组术中在肿瘤组织周围缓慢注射纳米碳混悬注射液（0．1～0．2ml／侧），等待3～5min。对照组及纳米碳组均行患侧甲状腺及峡部切除＋中央区淋巴结清扫＋对侧甲状腺叶切除术或者行对侧腺叶次仝切除术。记录每例手术显露甲状旁腺的数目，每例患者切除标本常规病理检查，记录甲状旁腺误切的数F1，记录术后患者口周、四肢麻木及抽搐等临床情况。结果纳米碳组术中共显露甲状旁腺70枚，对照组共显露62枚（x^2=23．821，P〈0．05）；纳米碳组病理标本中1例患者发现甲状旁腺1枚，对照组发现3例患者误切甲状旁腺，共计甲状旁腺4枚（x^2=89．393，P〈0．05）；术后纳米碳组2例患者术后第3天出现口周麻木症状，对照组6例患者术后m现口周麻木症状。结论甲状腺癌手术中应用纳米碳混悬注射液可以起到保护甲状旁腺的作用。

Objective To study the protective effect of carbon nanoparticles on parathyroid glands in the operation of thyroid carcinoma. Methods 56 thyroid carcinoma patients treated at our hospital from March, 2013 to March, 2015 were selected and were randomly divided into an carbon nanoparticle group and a control group. The carbon nanoparticle group were injected carbon nanoparticles around tumor tissue 0.1 - 0.2 ml/lateral 3 - 5 minutes before the operation. The excision of thyroid carcinoma and lymph node in central region dissection were performed in both groups. The number of parathyroid glands founded in the operation and parathyroid cut by mistake were counted respectively. The patients with mouth week or limb numbness were observed. Results The total number of parathyroid glands founded during the operation was 70 in the carbon nanoparticle group and 62 in the control group（x 2=23.821, P〈0.05）. The number of parathyroid glands found by postoperative pathologic examination was 1 in in the carbon nanoparticle group and 4 in the control group（x 2= 89.393, P〈0.05）. 2 patients got mouth numb in the carbon nanoparticle group and 6 in the control group three days after the operation. Conclusions Carbon nanoparticles could be used to protect parathyroid gland in thyroid carcinoma surgery.