纳米碳在腔镜甲状腺乳头状癌手术中的临床应用

Clinical application of carbon nanoparticle in endoscopic surgery for papillary thyroid carcinoma

目的探讨纳米碳在腔镜甲状腺乳头癌手术中中央区淋巴结清扫以及甲状旁腺保护方面的应用价值。方法回顾性分析2018年1月至2020年1月甘肃省人民医院普外科收治的102例初治甲状腺乳头状癌患者资料,所有患者均行腔镜下甲状腺腺叶切除加患侧中央区淋巴结清扫术,其中50例术中注射纳米碳(纳米碳组),52例未经注射纳米碳(非纳米碳组),比较两组患者术后中央区淋巴结清扫枚数、微小淋巴结枚数、转移淋巴结枚数及其甲状旁腺误切率。结果两组患者均成功完成手术,纳米碳组平均每例中央区淋巴结清扫枚数、微小淋巴结枚数、转移淋巴结枚数均高于非纳米碳组(P<0.05),甲状旁腺误切率低于非纳米碳(P<0.05)。结论腔镜甲状腺乳头状癌手术中通过使用纳米碳可增加中央区淋巴结检出率,并能减少甲状旁腺的损伤,可达到更加彻底清扫中央区淋巴结的效果,同时又起到保护甲状旁腺的作用,具有临床推广价值。

Objective To investigate the application value of carbon nanoparticles in central lymph node dissection and parathyroid protection during endoscopic surgery for papillary thyroid carcinoma(PTC).Methods The clinical data of 102 patients with primary papillary thyroid carcinoma admitted to the Department of General Surgery of Gansu Provincial People’s Hospital from January 2018 to January 2020 were retrospectively analyzed.All patients underwent thyroidectomy plus central lymph node dissection,of which 50 cases underwent intraoperative injection of carbon nanoparticles(nanocarbon group),and the other 52 cases did not undergo injection of carbon nanoparticles(non-nanocarbon group).The number of dissected central lymph nodes,tiny lymph nodes,metastatic lymph nodes and the rate of parathyroid gland misresection were compared between the two groups.Results The two groups of patients successfully completed the operation,the average number of dissected central lymph nodes,tiny lymph node and metastatic lymph nodes in each case in the nanocarbon group were higher than those in the non-nanocarbon group(P<0.05),and the parathyroid gland misresection rate was lower than that of non-nanocarbon group(P<0.05).Conclusion The use of carbon nanoparticles in endoscopic surgery for papillary thyroid carcinoma can increase the detection rate of central compartment lymph nodes,reduce the damage of parathyroid glands,achieve a more thorough dissection of central lymph nodes,and play a role in protecting the parathyroid glands,it is worthy of being popularized in clinical application.