纳米碳悬浮液在cN0甲状腺乳头状癌单侧中央区淋巴结清扫术中的应用

摘要

Objective:To study the value of carbon nanoparticles in unilateral central lymph node dissection for patient with cN0 papillary thyroid carcinoma. Methods:The data of 96 patients with cN0 papillary thyroid carcinoma from July 2014 to June 2015 were analyzed retrospectively( trial group). The control group was the other 98 patients from June 2013 to June 2014. All patients underwent total thyroidectomy plus unilateral central lymph node dissec-tion. Carbon nanoparticles were injected beneath the ture capsule of thyroid gland in trial group. The number of lymph node harvested in surgery,the rate of lymph metastasis were counted. The incidence of postoperative complications in-cluding hypocalcemia and recurrent laryngeal nerve injure were compared between the two groups . Results:The number of lymph node harvested in trial group was much more than the control group[(8. 44 ± 2. 39)vs(4. 26 ± 1. 23)]. The rate of lymph metastasis as higher in trial group was much more than the control group(45. 9% vs 28. 1%). There was 1 case temporary recurrent laryngeal nerve injure in both group(the injure rate was 1. 1%). The incidence of temporary hypocalcemia in experimental group was much low than that in control group(15. 3% vs 29. 2%). There were no patients with permanent hypocalcemia nor recurrent laryngeal nerve injure in both group. Conclusion:Application of carbon nanoparticles in central lymph node dissection may harvest more lymph nodes,in-cease the detected rate of lymph metastasis,protect parathyroid and improve quality of surgery.%目的：探讨纳米碳在cN0甲状腺乳头状癌中央区淋巴结清扫术中的应用价值。方法：回顾分析2013年6月-2015年6月在我科手术治疗的cN0甲状腺乳头状癌患者资料。2013年6月-2014年6月治疗患者96例为对照组，2014年7月-2015年6月治疗患者98例为实验组，两组均行双侧甲状腺全切除术＋患侧中央区淋巴结清扫术。实验组术中在甲状腺真被膜下注射纳米碳悬液。比较两组清扫淋巴结数目、淋巴结阳性率、喉返神经及甲状旁腺的损伤率。结果：实验组清扫淋巴结数目多于对照组[（8.44±2.39）vs（4.26±1.23）]，实验组淋巴结转移检出率高于对照组（45.9% vs 28.1%）。两组暂时性喉返神经损伤1例，两组均无永久性损伤病例。实验组发生暂时性甲状旁腺功能低下少于对照组（15.3% vs 29.2%）。两组均无永久性甲状旁腺功能低下发生。结论：在甲状腺乳头状癌中央区淋巴结清扫术中应用纳米碳悬浮液，能显著提高淋巴结检出数目，并提高淋巴结转移检出率，保护甲状旁腺，提高手术的质量。