纳米碳在甲状腺癌根治术中保护性作用的Meta分析

Meta-analysis of the Protective Effect of Carbon Nanoparticles on the Resection of Thyroid Cancer

目的通过Meta分析的方法定量评价纳米碳在甲状腺癌手术中保护甲状旁腺、喉返神经的能力和减少术后并发症的作用。方法全面检索中国知网、万方数据库、维普全文期刊、Embase、Pub Med和Medline等数据库,查找关于甲状腺癌和纳米碳的病例对照研究和队列研究文献。检索期限为2010年1月1日至2016年12月31日。运用Review Manager 5.3软件对数据进行Meta分析,以及文献异质性检验和偏倚评估。结果共纳入31篇研究文献,Meta分析结果显示:纳米碳组甲状旁腺误切率低于常规手术组[OR=0.14,95%CI(0.10,0.20),P<0.00001];与常规手术组相比,纳米碳组术后发生甲状旁腺功能减退症[OR=0.25,95%CI(0.19,0.33),P<0.00001]和低钙血症[OR=0.33,95%CI(0.27,0.41),P<0.00001]的发生率降低。结论纳米碳在甲状腺癌根治术中有助于甲状旁腺、喉返神经的保护,从而减少术后甲状旁腺功能减退症、低钙血症的发生。

Objective The purpose of this study was to quantitatively evaluate the benefit of carbon nanoparticles in protecting parathyroid glands,recurrent laryngeal nerves and reducing postoperative complications in resection of thyroid cancer.Methods A comprehensive search relating to the use of carbon nanoparticles in resection of thyroid cancer was applied to China National Knowledge Internet（CNKI）,Wanfang Database,CQVIP,Embase,Pub Med and Medline and other databases.In addition,the search period was from January 1,2010 to December 31,2016.We used Review Manager 5.3 software to analyze the data of Meta-analysis,including the heterogeneity testing and bias assessment.Results In this study,31 studies were included.Meta-analysis showed that the odds ratio of error cutting parathyroid glands in carbon nanoparticles group was significantly lower than that in routine surgery[OR=0.14,95% CI（0.10,0.20）,P〈0.00001].The incidence of postoperative hypoparathyroidism[OR=0.25,95%CI（0.19,0.33）,P〈0.00001]and hypocalcemia[OR=0.33,95%CI（0.27,0.41）,P〈0.00001]was lower in the carbon nanoparticles group than in the conventional surgery group,and the difference was statistically significant.Conclusion The using of carbon nanoparticles in resection of thyroid cancer can help to protect the parathyroid,recurrent laryngeal nerves and thus reducing the postoperative hypoparathyroidism and hypocalcemia.