纳米碳在甲状腺癌手术中的应用

Application of carbon nanoparticles in thyroid cancer surgery

目的探讨纳米碳在甲状腺癌手术中对淋巴结清扫及甲状旁腺保护的应用价值。方法回顾性分析2018年1月—2019年6月收治的94例甲状腺癌手术情况,所有患者均行甲状腺全切及颈中央区淋巴结清扫术,根据术中是否应用纳米碳将其分为实验组(54例)和对照组(40例),对照组不使用纳米碳,实验组术中应用纳米碳。收集患者一般情况及术后检出淋巴结的数量与转移数量,比较术前和术后3、30 d患者血清甲状旁腺素(PTH)与血钙的差异。结果两组间年龄、性别、术后测量肿瘤大小及TNM分期等基本情况比较无差异(P>0.05)。实验组检出淋巴结数平均(9.80±4.80)枚,对照组检出淋巴结数平均(6.95±3.86)枚,实验组转移淋巴结数与对照组转移淋巴结数相比差异具有统计学意义(χ~2=13.006,P<0.05)。两组患者术前及术后3、30 d的血钙和PTH均无差异(P>0.05)。结论甲状腺癌手术中应用纳米碳可显著增加检获淋巴结的数量,提高转移淋巴结清除的阳性率,但对甲状旁腺的保护作用不明显。

Objective To investigate the application value of carbon nanoparticles in lymph node dissection and parathyroid gland protection during thyroid cancer surgery.Methods Clinical data of 94 patients undergoing thyroid cancer surgery in our hospital from Jan 2018 to June 2019 were analyzed retrospectively.All patients underwent total thyroidectomy and central lymph node dissection.They were divided into experimental group(54 cases)and control group(40 cases).Carbon nanoparticles were intraoperatively applied to the patients of the experimental group and not to those of the control group.The general data of all the patients and the number of detected and metastatic lymph nodes were collected.Preoperative serum levels of parathyroid hormone(PTH)and calcium and those at 3 d and 30 d after operation were measured.Results The differences in patients’age,gender,tumor size and TNM stage between the two groups were statistically insignificant(all P>0.05).The average numbers of lymph nodes detected in the experimental group and the control group were(9.80±4.80)and(6.95±3.86),and the difference was statistically significant(χ2=13.006,P<0.05).There were no differences in serum levels of calcium and PTH between the two groups at all time points(all P>0.05).Conclusion The application of carbon nanoparticles during thyroid cancer surgery can significantly increase the number of lymph nodes detected and improve the positive rate of metastatic lymph node clearance with unobvious protective effect on parathyroid gland.