纳米炭混悬液与亚甲蓝在甲状腺癌扩大根治术中的应用

Clinical Application of Nano-carbon Suspension and Methylene Blue in Extended Radical Resection of Thyroid Cancer

目的:探讨纳米炭混悬液与亚甲蓝在甲状腺癌扩大根治术中的应用效果。方法:选取84例甲状腺癌患者,根据手术治疗方案分为对照组与观察组,各42例。对照组采用亚甲蓝辅助甲状腺癌扩大根治术治疗,观察组采用纳米炭混悬液辅助甲状腺癌扩大根治术治疗,比较2组手术结果。结果:对照组共清除163个中央区淋巴结,平均(3.88±1.34)个,观察组共清除188个中央区淋巴结,平均(4.51±1.33)个;观察组平均淋巴结清除数明显多于对照组,差异有统计学意义(P<0.05)。对照组转移淋巴结检出数32个(转移率19.63%),观察组转移淋巴结检出数40个(转移率21.28%);2组患者转移淋巴结检出数、淋巴结转移率比较无统计学意义(P>0.05)。2组术前血钙、PTH指标与术后喉返神经损伤、甲状旁腺误切发生率比较无统计学意义(P>0.05);术后1 d,2组患者血钙、PTH指标均明显下降而术后2 d均上升,术后1 d观察组患者血钙指标明显高于对照组,术后1 d及3 d观察组患者血钙、PTH指标明显高于对照组;观察组患者术后发生喉返神经损伤、甲状旁腺误切、术后暂时性低血钙、暂时性甲状旁腺功能减退等不良反应率(14.29%)明显低于对照组(50.00%),差异有统计学意义(P<0.05)。结论:纳米炭混悬液辅助甲状腺癌扩大根治术可有效提高淋巴结清除率,降低术后低血钙、甲状旁腺功能减退发生风险。

Objective:To compare the efficacy of carbon nanoparticles suspension and methylene blue in the extended radical resection of thyroid cancer.Methods:84 patients with thyroid cancer were divided into two groups:Control Group(n=42)and Observation Group(n=42).The control group was treated with methylene blue assisted extended radical resection of thyroid cancer,the observation group was treated with nano-carbon suspension assisted extended radical operation of thyroid cancer,and the effects of the two groups were compared.Results:A total of 163 central district lymph nodes were removed in the control group(3.88±1.34),188 Central District lymph nodes were removed in the observation group(4.51±1.33),and 32 metastatic lymph nodes were detected in the control group(19.63%),the number of metastatic lymph nodes in the observation group was 40(21.28%),the number of metastatic lymph nodes and the rate of metastatic lymph nodes in the two groups were not statistically significant(P>0.05),and the average number of lymph node clearance in the observation group was significantly more than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference between preoperative serum calcium,PTH and postoperative recurrent laryngeal nerve injury and parathyroidectomy(P>0.05),but serum calcium and PTH decreased significantly on the 1st day and increased on the 2nd day after operation,the Serum Calcium and PTH of the patients in the observation group were significantly higher than those in the control group on the 1st and 3rd day after operation,The adverse reaction rates of the two groups of patients with postoperative recurrent laryngeal nerve injury,missection of parathyroid glands,postoperative temporary hypocalcemia,and temporary hypoparathyroidism were significantly lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion:Carbon nanoparticle suspension can effectively improve the lymph node clearance rate and reduce the risk of hypocalcemia and hypoparathyroidism after thyroid cancer operation.