纳米碳混悬液在甲状腺微小癌门诊手术中的应用

Clinical application of carbon nanoparticles suspension in outpatient thyroid microcarcinoma surgery

目的近年来,很多研究表明纳米碳可有效保护甲状旁腺。但尚无在门诊甲状腺手术中应用。文中旨在观察甲状腺微小癌门诊手术中应用纳米碳混悬液注射剂对手术及其预后的影响。方法回顾性分析2015年1月到6月南京南京军区南京总医院行甲状腺微小癌门诊手术的65例患者的临床资料,根据是否在甲状腺内注射纳米碳混悬液分为纳米碳组(n=33)和对照组(n=32)。比较2组的手术情况、病理学资料、术后并发症、术后住院时间及术后第1天血C反应蛋白(C-reactive protein,CRP)和血钙等。结果纳米碳组中央区淋巴结平均每例患者检出枚数明显高于对照组[(8.21±2.08)vs(5.57±2.38)枚,P=0.004]。纳米碳组手术中无甲状腺旁腺损伤,对照组误切5枚甲状腺旁腺,2组差异有统计学意义(P=0.028)。对照组有3例患者出现皮肤麻木,纳米碳组无皮肤麻木者。纳米碳组术后住院时间较对照组明显降低[(31.09±6.62)vs(35.75±7.37)h,P=0.009]。纳米碳组术后第1天CRP水平明显低于对照组[(7.17±5.20)vs(9.87±5.60)mg/L,P=0.048],血钙水平明显高于对照组[(2.07±0.17)vs(1.98±0.20)mmol/L,P=0.036]。结论甲状腺微小癌门诊手术应用纳米碳混悬液可以保护甲状旁腺,减少手术应激,加快患者康复。

Objective Recently a lot of studies have shown carbon nanoparticles can protect parathyroid, however, there is no application in outpatient thyroid operation. The article was to investigate the influence of carbon nanoparticles suspension （ CNS） injection on the operation and prognosis of outpatient thyroid microcarcinoma（TMC） surgery. Methods Retrospective analysis was conducted on the clinical data of 65 patients who underwent outpatient TMC surgery from January to June in 2015 in our hospital. The patients were divided into 2 groups：33 patients in trial group were injected with CNS, and the other 32 patients in control group underwent conventional surgery. Comparison was made in operation information, pathologic data, postoperative complications, postoperative hospital stay as well as Creactive protein（CRP） and blood calcium of the first day after operation between the two groups. Results The average number of VI region lymph nodes in trial group（8.21±2.08）was significantly higher than that of control group（P=0.004）. Removal of 5 parathyroid glands for mistake was detected in control group, but no removal of parathyroid gland was detected in trial group, showing significant difference （P=0.028）. 3 patients in control group had numbness in skin, while none in trial group. The hospital stay of trial group was lowered significantly in comparison to that of control group（[31.09±6.62] vs [35.75±7.37], P=0.009）. The average Creactive protein （ CRP ） of the first day after operation in trial group was much lower that of control group（[7.17±5.20] vs [9.87±5.60] mg/L, P=0.048）. The average blood calcium of the first day in trial group was much higher than that of control group＆amp;nbsp;（[2.07±0.17] vs [1.98±0.20] mmol/L, P=0.036）. Conclusion Outpatient TMC surgery injected with carbon nanoparticles suspension can protect parathyroid gland function, reduce surgical stress and accelerate recovery.