术前与术中注射纳米碳在腔镜甲状腺癌根治术中的应用

Application of carbon nanoparticles injection before and during operation in endoscopic radical thyroidectomy

目的探讨术前与术中注射纳米碳在腔镜甲状腺癌根治术中的应用价值。方法回顾性分析行腔镜单侧甲状腺癌根治术120例患者的临床资料,根据纳米碳使用情况分为两组:术前组(98例)采取术前超声引导经皮注射纳米碳,术中组(22例)采取术中注射纳米碳。比较两组患者中央区淋巴结(CLN)清扫和转移情况以及术后并发症发生情况。结果两组患者临床资料比较无统计学差异(P>0.05)。术前组CLN清扫数目[6.00(3.75,8.00)枚vs.3.00(1.75,6.00)枚]和转移数目[1.00(0,3.00)枚vs.0(0,0.25)枚]多于术中组,转移率高于术中组(51.0%vs.22.7%)(P<0.05)。患者术后均无出血、声音嘶哑、饮水呛咳发生。结论相较于术中注射纳米碳,术前超声引导注射纳米碳操作简单、方便,能够增加CLN清扫数目和转移率,且不增加术后并发症。

Objective To investigate the application value of carbon nanoparticles injection before and during operation in endoscopic radical thyroidectomy.Methods The clinical data of 120 patients undergoing endoscopic radical thyroidectomy were retrospectively analyzed.The patients were divided into two groups.Group A(98 cases)received ultrasound-guided injection of carbon nanoparticles before operation and group B(22 cases)was injected with carbon nanoparticles during operation.The central regional lymph node(CLN)dissection,metastasis and postoperative complications were compared between the two groups.Results There was no statistical difference in clinical data between the two groups(P>0.05).The number of CLN dissection[6.00(3.75,8.00)pieces vs.3.00(1.75,6.00)pieces]and the number of CLN metastasis[1.00(0,3.00)pieces vs.0(0,0.25)pieces]were more in group A than those in group B(P<0.05).The metastasis rate was higher in group A than that in group B(51.0%vs.22.7%)(P<0.05).No bleeding,hoarseness or cough after drinking water happened in two groups after operation.Conclusion Compared with injection of carbon nanoparticles during operation,ultrasound-guided injection of carbon nanoparticles before operation is simple and convenient,can increase the number of CLN dissection and metastasis rate,and does not increase the postoperative complications.