纳米炭混悬注射液在甲状腺癌淋巴结清扫术中的应用效果
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摘要
目的观察纳米炭混悬注射液用于甲状腺癌淋巴结清扫术的效果。方法选取本院2015年1月～2017年12月收治的60例分化型甲状腺癌患者作为研究对象,按随机数字表法分为观察组与对照组,各30例。观察组注射0.2 ml纳米炭混悬注射液,对照组注射0.2 ml亚甲蓝注射液,两组均行甲状腺全切术+中央区淋巴结清扫术+侧颈淋巴结清扫术。比较两组的淋巴结总检出数目、每例检出淋巴结数目、染色淋巴结检出数目、直径<2 mm淋巴结检出数目、淋巴结转移阳性率、淋巴结转移阳性率、转移淋巴结检出数目、染色的转移淋巴结检出数目、甲状旁腺误切率、术后并发症总发生率。结果观察组的淋巴结总检出数目、每例淋巴结检出数目、染色淋巴结检出数目、直径<2 mm淋巴结检出数目、转移淋巴结检出数目、染色的转移淋巴结检出数目均显著高于对照组(P<0.05)。两组的淋巴结转移阳性率与甲状旁腺误切率比较,差异无统计学意义(P>0.05)。观察组的术后并发症总发生率为10.00%,显著低于对照组的30.00%(P<0.05)。结论纳米炭混悬注射液应用于甲状腺癌手术中有助于全面了解淋巴结情况,可提高淋巴结清扫的准确性,有效保护甲状旁腺,能够减少并发症与医疗纠纷。
Objective To observe the effect of Carbon Nanoparticles Suspension Injection in lymph node dissection of thyroid cancer. Methods A total of 60 patients with differentiated thyroid cancer admitted to our hospital from January2015 to December 2017 were enrolled in the study. They were divided into the observation group and the control group according to the random number table method, with 30 cases in each group. The observation group injected 0.2 ml Carbon Nanoparticles Suspension Injection, while the control group injected 0.2 ml Methylthioninium Chloride Injection. Both groups was treated with total thyroidectomy and central lymph node dissection combined with lateral cervical lymph node dissection. The number of total detected lymph nodes, the number of lymph nodes detected in each case,the number of stained lymph nodes detected, the number of lymph nodes for diameter <2 mm, the positive rate of lymph node metastases, the number of metastatic lymph nodes detected, the number of stained metastatic lymph nodes detected, the parathyroid error rate, the total incidence of postoperative complications were compared between two groups. Results The total number of lymph nodes, the number of lymph nodes detected in each case, the number of stained lymph nodes detected, the number of lymph nodes for diameter <2 mm, number of metastatic lymph nodes detected and the number of stained metastatic lymph nodes detected in the observation group were significantly higher than those in the control group(P<0.05). There were no significant difference in the positive rate of lymph node metastases, the parathyroid error rate between the two groups(P>0.05), and the total incidence of postoperative complications in the observation group was 10.00%, which was significantly lower than 30.00% of the control group(P<0.05). Conclusion The application of Carbon Nanoparticles Suspension Injection in thyroid cancer surgery can help to understand the situation of lymph nodes, improve the accuracy of lymph node dissection, effectively protect parathyroid glands, reduce complications and medical disputes.
Objective To observe the effect of Carbon Nanoparticles Suspension Injection in lymph node dissection of thyroid cancer. Methods A total of 60 patients with differentiated thyroid cancer admitted to our hospital from January2015 to December 2017 were enrolled in the study. They were divided into the observation group and the control group according to the random number table method, with 30 cases in each group. The observation group injected 0.2 ml Carbon Nanoparticles Suspension Injection, while the control group injected 0.2 ml Methylthioninium Chloride Injection. Both groups was treated with total thyroidectomy and central lymph node dissection combined with lateral cervical lymph node dissection. The number of total detected lymph nodes, the number of lymph nodes detected in each case,the number of stained lymph nodes detected, the number of lymph nodes for diameter <2 mm, the positive rate of lymph node metastases, the number of metastatic lymph nodes detected, the number of stained metastatic lymph nodes detected, the parathyroid error rate, the total incidence of postoperative complications were compared between two groups. Results The total number of lymph nodes, the number of lymph nodes detected in each case, the number of stained lymph nodes detected, the number of lymph nodes for diameter <2 mm, number of metastatic lymph nodes detected and the number of stained metastatic lymph nodes detected in the observation group were significantly higher than those in the control group(P<0.05). There were no significant difference in the positive rate of lymph node metastases, the parathyroid error rate between the two groups(P>0.05), and the total incidence of postoperative complications in the observation group was 10.00%, which was significantly lower than 30.00% of the control group(P<0.05). Conclusion The application of Carbon Nanoparticles Suspension Injection in thyroid cancer surgery can help to understand the situation of lymph nodes, improve the accuracy of lymph node dissection, effectively protect parathyroid glands, reduce complications and medical disputes.
引文
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[15]孙小亮,鲁瑶,杨猛,等.纳米碳负显影技术在甲状腺全切联合中央组淋巴结清扫术中的应用[J].中日友好医院学报,2017,31(4):207-209,213.
[16]洪强,汪勇,王建军,等.术前胃镜下注射法纳米碳淋巴结示踪技术在腹腔镜胃癌根治术中的应用[J].中华医学杂志,2017,97(2):123-126.
[17]曹鋆,童创,武治国,等.甲状腺手术中甲状旁腺原位显露及保护技术的应用体会[J].安徽医学,2016,37(6):712-713.
[18]黎佩建,魏崴,李勇生,等.纳米炭淋巴结示踪剂在腔镜食管癌根治术中的应用[J].现代肿瘤医学,2017,25(17):2755-2757.
[19]陈柏庆,章健,张黎,等.纳米炭在胃癌病理标本微小淋巴结检测中的应用[J].广东医学,2017,38(7):1048-1051.
[20]孙善平,章阳,崔兆清,等.纳米炭淋巴结示踪剂在分化型甲状腺癌Ⅵ区淋巴结清扫中的应用[J].山东医药,2013,54(20):56-58.
[2]贝一冰,俞甲子,王雅平,等.甲状腺癌的超声诊断和淋巴结转移1023例分析[J].复旦学报(医学版),2014,41(5):658-661.
[3]彭琛,魏松锋,郑向前,等.1401例甲状腺微小乳头状癌临床病理特征及中央区淋巴结转移危险因素分析[J].中国肿瘤临床,2016,43(3):95-99.
[4]高文,梁军,赵腾,等.甲状腺乳头状癌淋巴结转移率与131I治疗后临床转归的关系[J].中国癌症杂志,2016,26(1):67-72.
[5]冯红芳,陈创,孙圣荣,等.1585例甲状腺癌的临床病理特点及总结分析[J].中国肿瘤临床,2015,42(2):77-81.
[6]李三荣,刘仁胜,刘小卫,等.探讨甲状腺全切术中甲状旁腺周围微循环的保护[J].华中科技大学学报(医学版),2016,45(5):559-562.
[7]宁迩玉,康杰,樊友本.纳米碳在分化型甲状腺癌术中应用的研究进展[J].中华临床医师杂志(电子版),2013,7(11):5043-5045.
[8]袁绍峰,孔祥东,卢江昆,等.纳米碳示踪剂在甲状腺癌中央组淋巴结清扫中的应用及临床意义[J].中国现代普通外科进展,2017,20(7):527-530.
[9]程卫,李继锋,邱伟,等.纳米炭混悬液在甲状腺癌颈淋巴结清扫中的临床应用[J].西部医学,2016,28(9):1230-1233.
[10]王玉林,王辉,巴颖,等.纳米碳示踪在甲状腺癌淋巴结清扫术中的应用研究[J].医学与哲学,2016,37(2):38-40.
[11]柳学文,李强,陈飞,等.3D腔镜在甲状腺全切及中央区淋巴结清扫术中的临床效果[J].南方医科大学学报,2017,37(6):842-846.
[12]杨显富,康欣,杨福,等.纳米碳示踪剂在甲状腺癌根治术中的应用效果研究[J].实用医院临床杂志,2017,14(5):158-160.
[13]徐其,董来荣,章波,等.纳米炭在甲状腺手术淋巴结清扫中的应用[J].中国中西医结合外科杂志,2016,22(6):599-601.
[14]白彦宏,张群伟,高权强,等.纳米炭注射剂在甲状腺癌行甲状腺全切加双侧中央区清扫中的效果[J].中国生化药物杂志,2016,36(3):151-153.
[15]孙小亮,鲁瑶,杨猛,等.纳米碳负显影技术在甲状腺全切联合中央组淋巴结清扫术中的应用[J].中日友好医院学报,2017,31(4):207-209,213.
[16]洪强,汪勇,王建军,等.术前胃镜下注射法纳米碳淋巴结示踪技术在腹腔镜胃癌根治术中的应用[J].中华医学杂志,2017,97(2):123-126.
[17]曹鋆,童创,武治国,等.甲状腺手术中甲状旁腺原位显露及保护技术的应用体会[J].安徽医学,2016,37(6):712-713.
[18]黎佩建,魏崴,李勇生,等.纳米炭淋巴结示踪剂在腔镜食管癌根治术中的应用[J].现代肿瘤医学,2017,25(17):2755-2757.
[19]陈柏庆,章健,张黎,等.纳米炭在胃癌病理标本微小淋巴结检测中的应用[J].广东医学,2017,38(7):1048-1051.
[20]孙善平,章阳,崔兆清,等.纳米炭淋巴结示踪剂在分化型甲状腺癌Ⅵ区淋巴结清扫中的应用[J].山东医药,2013,54(20):56-58.