纳米碳颗粒显色对甲状旁腺的保护作用

Protective effect of nano-carbon tracers on the parathyroid glands

背景:纳米碳示踪剂在恶性肿瘤诊治中的应用已有不少研究,关于纳米碳示踪剂在甲状腺癌手术中对甲状旁腺保护作用的研究不多。目的:研究甲状腺癌手术中纳米碳对甲状旁腺的保护作用。方法:将180例甲状腺癌患者随机分为纳米碳组和对照组,每组90例,对照组进行常规的甲状腺癌切除手术;纳米碳组于甲状腺内注射纳米碳示踪剂,然后进行甲状腺癌切除手术。对比两组手术时间、切口长度、术中出血量、术后住院时间、淋巴结清除个数、淋巴结转移情况、甲状旁腺功能减退情况、治疗后3 d血钙水平和甲状旁腺激素水平。结果与结论:两组手术时间、切口长度、术中出血量、术后住院时间、淋巴结转移率比较差异无显著性意义(P>0.05);纳米碳组淋巴结清除个数明显高于对照组(P<0.05),甲状旁腺误切率、甲状旁腺功能减退率、低血钙发生率、低甲状旁腺激素发生率明显低于对照组(P<0.05)。结果表明在甲状腺癌手术中,纳米碳颗粒示踪剂对甲状旁腺具有保护作用,可降低甲状旁腺的误切率,降低甲状旁腺功能减退的发生率,降低术后低血钙和低甲状旁腺激素的发生率。

BACKGROUND： So far there are many studies about the uses of nano-carbon tracers in the diagnosis and treatment of malignancies. However, little has been reported on the mechanism underlying protective effect of nano-carbon tracers on the parathyroid glands during thyroid cancer surgery. OBJECTIVE： To study the protective effect of nano-carbon tracers on the parathyroid in thyroid cancer surgery. METHODS： 180 cases of thyroid cancer were randomly divided into nano-carbon and control groups （n=90 per group）： patients in the nano-carbon group were injected with nano-carbon tracers into the thyroid before surgery, and those in the control group underwent routine thyroid cancer surgery. Then comparisons of the operating time, incision length, blood loss, postoperative hospital stay, number of lymph node dissection, lymph node metastasis as well as hypoparathyroidism rate were performed between two groups. Besides, levels of serum calcium and parathyroid hormone in the two groups were detected at 3 days after surgery. RESULTS AND CONCLUSION： There were no significant differences in the operating time, incision length, blood loss, postoperative hospital stay and lymph node metastasis between the two groups （P 〉 0.05）. The number of dissected lymph nodes of nano-carbon group was significantly higher than that of control group （P 〈 0.05）; the mis-resection rate of parathyroid and hypoparathyroidism of nano-carbon group were significantly lower than those of control group （P 〈 0.05）. Furthermore, the incidences of hypocalcemia and low parathyroid hormone of nano-carbon group were significantly lower than those of control group （P 〈 0.05）. These results suggest that the nano-carbon tracer plays a protective role on the parathyroid glands in thyroid cancer surgery, which can reduce the mis-resection rate of parathyroid, as well as the incidences of hypoparathyroidism, hvpocalcemia and low-level parathvroid hormone.