纳米碳甲状旁腺负显影技术在甲状腺癌手术中的应用

Application of Carbon Nano Negative Parathyroid Imaging in Thyroid Cancer Surgery

目的探讨在甲状腺癌根治术中应用纳米碳显影技术彻底清扫淋巴结同时保护甲状旁腺的价值.方法将130例甲状腺癌随机平均分为实验组与对照组各65例,实验组注射纳米碳混悬液后按黑染淋巴结的范围清扫患侧VI区淋巴结,对照组常规清扫患侧VI区淋巴结.对2组淋巴结清扫总数、淋巴结转移数、甲状旁腺误切数、发生暂时性低钙血症和永久性低钙血症例数、淋巴结转移率和甲状腺误切率进行比较分析.结果实验组共清扫淋巴结406枚,对照组共清扫淋巴结267枚,实验组淋巴结转移数为106枚,而对照组63枚,2组间差异均有统计学意义(P<0.01).实验组与对照组淋巴结转移率分别为26.11%和23.61%,2组间差异无统计学意义(P>0.05);实验组术后未找到甲状旁腺,发生短暂性低钙血症2例,未发生永久性低钙血症,对照组术后找到甲状旁腺组织4例,发生短暂性低钙血症12例,发生永久性低钙血症4例,2组间差异具有统计学意义(P<0.05);实验组和对照组甲状旁腺误切率分别为0%和1.08%,2组间差异具有统计学意义(P<0.05).结论纳米碳在甲状腺癌根治术中能够使VI区淋巴结得到很好的显影,而甲状旁腺呈负显影,有利于淋巴结彻底清扫,避免甲状旁腺的误切,提高了手术精度及安全性.

Objective To explore the application of carbon nano negative parathyroid imaging in radical operation of thyroid carcinoma.Methods 130 cases of thyroid cancer were randomly divided into experimental group and control group,each group had 65 cases,The experimental group was injected with nano carbon suspension to clean the ipsilateral VI lymph nodes according to the range of black stained lymph nodes,patients in control group were treated with VI lymph node dissection.Of the two groups of total lymph nodes,the number of lymph node metastasis,inadvertent parathyroidectomy,a transient hypocalcemia and permanent hypocalcemia cases,lymph node metastasis rate and thyroid resection rate were analyzed.Result In the experimental group,406 lymph nodes were dissected,and the control group was given a total of 267 lymph nodes.The number of lymph node metastasis in the experimental group was 106,while the control group was 63,the difference between the two groups was statistically significant（P〈0.01）.The lymph node metastasis rate of the experimental group and the control group were 26.11% and 23.61%,respectively.There was no significant difference between the two groups（P〈0.05）.The experimental group did not find the parathyroid gland,transient hypocalcemia in 2 cases,no permanent hypocalcemia,find the parathyroid tissue after surgery in the control group of 4 cases,12 cases of transient hypocalcemia,4 cases of permanent hypocalcemia,differences between the two groups had statistical significance（P〈0.05）.The experimental group and the control group were 0% and 1.08%,respectively,the difference between the two groups was statistically significant（P〈0.05）.Conclusion Nano carbon in the radical operation of thyroid cancer can make the VI region lymph node is very good imaging,but the parathyroid is negative imaging,It is helpful for the dissection of lymph nodes,avoiding the wrong cutting of parathyroid gland,and improving the accuracy and safety of operation.