目的：探讨纳米碳标记Delphian淋巴结的方法和可行性及临床意义。方法甲乳外科136例以甲状腺乳头状癌入院并拟行甲状腺癌根治手术的患者，随机分为对照组（A、B组）、实验组（C、D组），对比A组和C组、B组和D组、A+B组与C+D组淋巴结清扫总数、Delphian淋巴结数量和发生甲状旁腺功能减退的概率。统计分析各组Delphian淋巴结与原发肿瘤状态、中央区淋巴结和（或）侧颈区淋巴结转移数量的相关性。结果 Delphian淋巴结与原发肿瘤状态、中央区和侧颈区淋巴结转移状态呈正相关。术中使用纳米碳组清扫的中央区、侧颈区、Delphian淋巴结数目均大于对照组（P＜0.05），实验组甲状旁腺损伤的例数少于对照组（5例 vs 12例，P＜0.05）。结论纳米碳标记Delphian淋巴结可作为侧颈区清扫的客观依据和评估甲状腺癌预后一项简便、可行的指标，增加了Delphian淋巴结清扫的彻底性，增加了中央区淋巴结及侧颈区淋巴结清扫的数量，减少了术后甲状旁腺功能减退的发生。%Objective To explore methods and feasibility of the nanometer carbon labeling Delphian lymph nodes and its clinical significance. Methods 136 patients with thyroid papillary carcinoma undergone thyroid cancer radical surgery , were randomly divided into the control group (group A, B) and the experimental group (group C, D), compared the total num-ber of lymph nodes, number of Delphian lymph nodes, and the probability of occurring parathyroid function decline between group A and group C, group B and group D, group A+B and group C+D. Statistically analysed the relationship of Delphian lymph node and state of primary tumor, lymph node in central region and (or) lateral neck lymph node metastasis number be-tween every groups. Results Delphian lymph node and state of primary tumor, central and lateral neck lymph node metastasis status were positively correlated. Intraoperative use of nanometer carbon group of central region, lateral neck area, cleaning the Delphian lymph node number were greater than the control group (P<0.05). Parathyroid injury risk of experimental group was lower than the control group (5 cases vs 12 cases, P<0.05). Conclusion Nanometer carbon labeling Delphian lymph nodes can be used as a left-edge area cleaning the objective basis of thyroid carcinoma and evaluate the prognosis of a simple and fea-sible, which can improve the completeness of the Delphian lymph node cleaning, increase the number of the lymph node and their neck lymph node in central region and reduce the postoperative parathyroid function decline.
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