纳米碳和亚甲蓝在结直肠癌根治术淋巴结检出中的应用

摘要

Objective To investigate the clinical value and significance of lymph node labeling in colorectal cancer surgery. Methods Retrospectively analyze the clinical data of 102 patients with colorectal cancer radical surgery in our department from Feb 2014 to Mar 2016. A-mong the patients,Carbon nanoparticles were injected into the submucosa around the tumor in 25 patients 1 day before the operation(group A), carbon nanoparticles were injected into the subserosa around the tumor in 26 patients during the operation(group B),and methylene blue were in-jected into the subserosa around the tumor in 21 patients during the operation(group C),while 30 patients received operation directly(group D).The number of cleared lymph nodes,tiny lymph nodes( 0. 05). Conclusion As lymphatic tracer,carbon nanoparticles is better than methylene blue,and using it one day before the operation is su-perior than during the operation. It can help to improve the lymph node detection rate,the accuracy of pathological staging,and guide the postop-erative adjuvant therapy.%目的 探讨纳米碳和亚甲蓝淋巴结示踪剂在结直肠癌根治手术中临床应用的价值和意义.方法 将2014年8月至2016年3月102例行结直肠癌根治手术患者随机分为4组;其中25例患者于术前一天在电子肠镜下行肿瘤周围黏膜下纳米碳注射(A组),26例患者于术中在腹腔镜下行肿瘤周围浆膜下纳米碳注射(B组),21例患者于术中在腹腔镜下行肿瘤周围浆膜下亚甲蓝注射(C组),30例患者直接手术(D组).分析比较各组淋巴结检出数,微小淋巴结(0.05),Ⅲ期患者平均染色淋巴结数明显低于I期、Ⅱ期,差异有显著性(P0.05).结论 术前一天使用纳米碳示踪剂能明显提高淋巴结检出率尤其是微小淋巴结检出率,有助于更准确地进行病理分期,指导术后化疗,改善预后.