纳米活性炭在胃癌根治术中的临床应用研究

Clinical Application of Nano-carbon Particles for Radical Gastrectomy

目的评价纳米活性炭在胃癌根治术中的淋巴示踪作用。方法 80例胃癌患者随机分为示踪组(n=40)和对照组(n=40),示踪组患者术中于癌灶外0.5~1 cm浆膜下注射纳米活性炭进行胃周淋巴结示踪,对照组患者直接手术,比较两组清扫淋巴结的数目、淋巴结黑染数目。结果示踪组患者每例清扫淋巴结(38.3±3.1)枚,明显高于对照组的(17.3±1.2)枚,P<0.05。示踪组患者淋巴结的黑染率为79.84%(1220/1528),在经病理证实有转移的312枚淋巴结中,黑染的淋巴结数目为189枚(黑染率60.58%);未黑染的淋巴结数目为123枚(39.42%),两者差异有统计学意义(P<0.05)。结论采用纳米活性炭示踪剂可有助于胃癌根治术中辨认淋巴结,增加清扫淋巴结的数目,从而加强淋巴结清扫的彻底性,对改善患者的预后有重要意义。

Objective To evaluate the lymphatic tracing effects of nano-carbon particles for radical gastrectomy. Methods 80 cases of gastric cancer patients were randomly divided into the experimental group（ n = 40） and control group（ n = 40）.In the experimental group,nano-carbon was injected into the subserosa outside the 0. 5-1 cm around the tumor for lymphatic tracing before operation,while no tracer was given in the control group. Then the number of lymph nodes dissected,blacken rate of lymph nodes of the 2 groups were compared. Results The number of lymph nodes dissected in the experimental group was 38. 3 ± 3. 1,which was significantly more than that of the control group 17. 3 ± 1. 2,P〈0. 05. The blacken rate of lymph nodes of the experimental group was 79. 84%（1 220/1528）,In 312 lymph nodes proved pathologically to have metastasis,the blacken rate of metastatic lymph nodes was 60. 58%（189/312）,which was significantly higher than the non-blacken rate of metastatic lymph nodes（39. 42%,123/312）,P〈0. 05. Conclusion Lymph node dissection guided by activated carbon tracer in gastric cancer would conduce to identify lymph node during operation and enhance dissected efficacy of lymph nodes. So,It is important to improve the prognosis of the patient.