纳米炭在甲状腺癌手术治疗中作用的Meta分析

Meta-analysis of the function of carbon nanoparticles use in the surgery of thyroid cancers

目的系统评价纳米炭在甲状腺癌手术治疗中的作用。方法计算机检索Pubmed、Web of science、Cochrane Library、CNKI、万方、维普数据库,中文检索关键词为纳米碳、纳米炭、甲状腺癌、甲状腺恶性肿瘤,英文关键词为nano carbon、nano-carbon、carbon nanoparticles、nano-carbon parathyroid negative imaging technique、thyroids neoplasms、thyroidc ancer、thyroid carcinoma。检索时间从数据库建库到2020年3月10日。手动检索文章参考文献。由2名研究人员分别筛选、整理数据,并对文章进行质量评价及发表偏倚评估。使用Revman5.3进行数据分析。结果纳入随机对照研究26篇,共2291例患者,其中实验组1149例,对照组1142例。结果发现,应用纳米炭的试验组比空白对照组术后并发症发生率均显著降低,差异均有统计学意义,其中包括甲状旁腺误切率(OR=0.24,95%CI:0.16~0.34,P<0.001)、术后甲状旁腺功能减退发病率(OR=0.38,95%CI:0.28~0.52,P<0.001)、术后低钙血症发病率(OR=0.40,95%CI:0.30~0.54,P<0.001)及喉返神经损伤率(OR=0.50,95%CI:0.31~0.81,P<0.001)。结论术中使用纳米炭示踪技术能够减少甲状腺癌切除术产生的并发症,值得临床使用。

Objective To systematically evaluate the role of nanocarbon in the surgical treatment of thyroid cancer.Method Searched Pubmed database,Web of Science,Cochrane Library,CNKI database,Wanfang database and VIP database for researches related to nanocarbon and thyroid cancer.The search key words included nano carbon,nano-carbon,carbon nanoparticles,nano-carbon parathyroid negative imaging technique,thyroid neoplasms,thyroid cancer,thyroid carcinoma.And also manually retrieved article references.The search time was from the establishment of the database to March 10,2020.Two researchers separately screened and sorted out the data,and evaluated the quality of the articles and evaluated the publication bias.Revman 5.3 was used for data analysis.Results Twenty-six randomized controlled studies were included,with a total of 2291 patients,including 1149 in the test group and 1142 in the control group.The results showed that the postoperative complications rate of the test group using nanocarbon was significantly lower than that of the blank control group,and the differences were statistically significant,including the parathyroid erroneous excision rate(OR=0.24,95%CI:0.16-0.34,P<0.001),the incidence of postoperative hypoparathyroidism(OR=0.38,95%CI:0.28-0.52,P<0.001),the incidence of postoperative hypocalcemia(OR=0.40,95%CI:0.30-0.54,P<0.001)and the recurrent laryngeal nerve injury rate(OR=0.50,95%CI:0.31-0.81,P<0.001).Conclusion The use of nanocarbon tracing technology during the operation can reduce the complications of thyroid cancer resection and is worthy of clinical use.