纳米碳示踪剂在甲状腺髓样癌行甲状腺全切术及淋巴结转移清扫中的应用效果

Application of carbon nanoparticles tracer in medullary thyroid carcinoma patients with total thyroidectomy and lymph node dissection

目的探讨纳米碳示踪剂在甲状腺髓样癌行甲状腺全切术及淋巴结转移清扫中的应用效果。方法选取行甲状腺全切术及淋巴结清扫的56例患者,随机分为实验组和对照组各28例。对照组患者实施常规甲状腺全切术联合淋巴结清扫,实验组患者在纳米碳示踪显影后再进行甲状腺全切及淋巴结清扫术。比较2组患者手术时间、术中出血量、术后住院时间、甲状旁腺误切率、平均淋巴结清扫数量及淋巴结转移率,比较2组患者术前及术后甲状旁腺素及血钙水平,比较2组患者术后并发症发生率。结果 2组患者手术时间、术中出血量及术后住院时间无显著差异(P> 0. 05)。实验组甲状旁腺误切率显著低于对照组,平均清扫淋巴结数量及淋巴结转移率显著高于对照组(P <0. 05)。2组患者术前甲状旁腺素及血钙水平无显著差异(P> 0. 05),实验组患者术后上述指标均显著高于对照组(P <0. 05)。实验组术后并发症发生率显著低于对照组(P <0. 05)。结论纳米碳示踪剂在甲状腺髓样癌行甲状腺全切术及淋巴结清扫中具有较高的安全性,能够提高淋巴结清扫效率,降低对甲状旁腺的损伤及术后并发症发生率。

Objective To explore the application of carbon nanoparticles tracer in medullary thyroid carcinoma patients with total thyroidectomy and lymph node dissection. Methods Totally 56 patients with total thyroidectomy and lymph node dissection were selected and randomly divided into experimental group and control group, with 28 cases in each group. The control group was treated with conventional total thyroidectomy combined with lymph node dissection, while the experimental group was treated with the same operations after application of carbon nanoparticles tracer. The operation time, the amount of bleeding and the hospitalization time were compared between the two groups. The parathyroid dissection rate, the average dissection number of lymph node and the metastasis rate of lymph node were compared between the two groups, and theparathyroid hormone and blood were compared before and after the operation between the two groups. The incidence rate of postoperative complications in was compared between the two groups. Results There were no significant differences in operation time, intra-operative bleeding and postoperative hospital stay between the two groups （ P 〉0.05）. The rate of parathyroid parathyroidism in the experimental group was significantly lower than that in the control group, while the average number of lymph nodes and metastasis rate of lymph node were significantly higher than those of the control group （ P 〈0.05）. Before the operation, the levels of adenine and blood calcium showed no significant differences between two groups （ P 〉 0.05）, but the above indexes after operation in the experimental group were all significantly higher than the control group （ P 〈0.05）. The incidence rate of postoperative complications in experimental group was significantly lower than that of the control group （ P 〈0.05）. Conclusion The carbon nanotracer is safe in the thyroidectomy and lymph node dissection of patients with medullarythyroid carcinoma, and it can improve the efficiency of lymph node dissection, reduce the damage to parathyroid glands and the incidence rate of postoperative complications.