纳米碳混悬液示踪技术在腔镜下甲状腺癌根治术中的应用
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摘要
目的:探讨纳米碳混悬液示踪技术在腔镜下甲状腺癌根治术中的应用。方法:选取我院收治的120例甲状腺癌患者为研究对象,随机分为纳米碳组与对照组,每组各60例。对照组行腔镜下甲状腺癌根治术,纳米碳组注射纳米碳混悬液后行腔镜下甲状腺癌根治术。记录两组患者平均的淋巴结检获枚数及直径,术前及术后血钙水平及甲状旁腺术率,术后并发症的发生情况以及随访了解患者术后复发及生存情况。结果:纳米碳组的平均淋巴结检获枚数以及<5 mm淋巴结的检出率均显著高于对照组(P <0. 05);在甲状旁腺术与发音困难、手足麻木、声音嘶哑等并发症方面,两组比较差异无统计学意义(P> 0. 05),但术后纳米碳组的血钙水平显著高于对照组(P <0. 05),且低血钙症的发生率明显低于对照组(P <0. 05);至随访截止日期,纳米碳组的存活率、复发率与对照组比较,差异无统计学意义(P>0. 05)。结论:纳米碳示踪技术在腔镜下甲状腺癌根治术中有助于提高淋巴结清扫量及彻底性,同时对甲状旁腺具有保护作用。
Objective:To explore the application of the nanocarbon suspension tracer technique in laparoscopic radical operation of thyroid cancer. Methods:120 patients with thyroid cancer were selected and randomly divided into the nanocarbon group and the control group,60 patients in each group. The control group were treated with laparoscopic radical operation while the nanocarbon group were injected nanocarbon suspension based on the treatment used in the control group,with the average number of detected lymph nodes and their diameters,parathyroid surgery rates and blood calcium levels before and after operation,and the occurrence of postoperative complications recorded,and the postoperative recurrence and survival followed up. Results:The average number of detected lymph nodes and the detection rate of lymph nodes less than 5 mm in the nanocarbon group were significantly higher than those in the control group( P < 0. 05). There was no statistically significant difference in the parathyroid surgery and complications( such as dysphonia,numbness of hands and feet,and hoarseness) between the two groups( P > 0. 05),but the blood calcium level in the nanocarbon group after operation was significantly higher than that in the control group( P < 0. 05),and the incidence rate of hypocalcemia was significantly lower than that in the control group( P < 0. 05). Until the deadline of follow-up,there was no significant difference in the survival rate and recurrence rate between the nanocarbon group and the control group( P > 0. 05). Conclusion:The nanocarbon tracer technique can help to increase the amount and thoroughness of lymph node dissection during laparoscopic radical operation of thyroid cancer,and it can also protect the parathyroid glands.
Objective:To explore the application of the nanocarbon suspension tracer technique in laparoscopic radical operation of thyroid cancer. Methods:120 patients with thyroid cancer were selected and randomly divided into the nanocarbon group and the control group,60 patients in each group. The control group were treated with laparoscopic radical operation while the nanocarbon group were injected nanocarbon suspension based on the treatment used in the control group,with the average number of detected lymph nodes and their diameters,parathyroid surgery rates and blood calcium levels before and after operation,and the occurrence of postoperative complications recorded,and the postoperative recurrence and survival followed up. Results:The average number of detected lymph nodes and the detection rate of lymph nodes less than 5 mm in the nanocarbon group were significantly higher than those in the control group( P < 0. 05). There was no statistically significant difference in the parathyroid surgery and complications( such as dysphonia,numbness of hands and feet,and hoarseness) between the two groups( P > 0. 05),but the blood calcium level in the nanocarbon group after operation was significantly higher than that in the control group( P < 0. 05),and the incidence rate of hypocalcemia was significantly lower than that in the control group( P < 0. 05). Until the deadline of follow-up,there was no significant difference in the survival rate and recurrence rate between the nanocarbon group and the control group( P > 0. 05). Conclusion:The nanocarbon tracer technique can help to increase the amount and thoroughness of lymph node dissection during laparoscopic radical operation of thyroid cancer,and it can also protect the parathyroid glands.
引文
[1]田文,郗洪庆.甲状腺癌病人生存现状分析[J].中国实用外科杂志,2016,36(5):489-493.
[2]吴毅,孙团起.甲状腺癌手术质量控制争议与共识[J].中国实用外科杂志,2016,36(1):34-37.
[3]葛现才,张勤,徐宪辉,等.纳米碳示踪技术在结肠癌根治术淋巴结清扫中应用价值研究[J].中国实用外科杂志,2016,36(8):904-906.
[4]张波,徐景竹,吴琼. 2015年美国甲状腺学会《成人甲状腺结节与分化型甲状腺癌诊治指南》解读:超声部分[J].中国癌症杂志,2016,26(1):19-24.
[5]董芬,张彪,单广良.中国甲状腺癌的流行现状和影响因素[J].中国癌症杂志,2016,26(1):47-52.
[6]张春霞,杨丽,王文超.手术治疗分化型甲状腺癌76例临床分析[J].现代肿瘤医学,2016,24(5):724-726.
[7]李翔,刘雪宜,史振超,等.完全腔镜下分化型甲状腺癌根治术的临床应用[J].佛山科学技术学院学报(自然科学版),2016,34(2):72-75.
[8]姚金梅.腔镜下甲状腺癌根治术的围手术期护理[J].中外医疗,2016,35(33):167-169.
[9]王岩,王培顺,李淑琴,等.纳米碳混悬液示踪技术在老年甲状腺乳头状癌中央区淋巴结清扫术中的应用价值[J].中国老年学杂志,2017,37(5):1166-1168.
[10]张娟娟,王少华.纳米碳混悬液在甲状腺微小癌门诊手术中的应用[J].医学研究生学报,2016,29(10):1063-1066.
[11]王新征,李玉梅,刘金彪,等.纳米碳甲状旁腺淋巴负显影技术在甲状腺癌手术中对甲状旁腺功能的保护作用[J].中国实用医药,2016,11(12):48-49.
[12]王玉林,王辉,巴颖.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(B),2016,37(1):38-40.
[13]邓正明,孔凡萍,葛少华,等.纳米碳混悬液在甲状腺癌颈部淋巴结清扫和甲状旁腺保护中的临床应用[J].南京医科大学学报(自然科学版),2016,36(12):1456-1460.
[14]陈泳,单伟颖.纳米碳颗粒显色对甲状旁腺的保护作用[J].中国组织工程研究,2016,20(30):4476-4482.
[15]宋小康,李兴华,毛常青,等.纳米碳甲状旁腺负显影辨认保护技术在甲状腺癌手术中的应用[J].海南医学,2017,28(21):3548-3550.
[2]吴毅,孙团起.甲状腺癌手术质量控制争议与共识[J].中国实用外科杂志,2016,36(1):34-37.
[3]葛现才,张勤,徐宪辉,等.纳米碳示踪技术在结肠癌根治术淋巴结清扫中应用价值研究[J].中国实用外科杂志,2016,36(8):904-906.
[4]张波,徐景竹,吴琼. 2015年美国甲状腺学会《成人甲状腺结节与分化型甲状腺癌诊治指南》解读:超声部分[J].中国癌症杂志,2016,26(1):19-24.
[5]董芬,张彪,单广良.中国甲状腺癌的流行现状和影响因素[J].中国癌症杂志,2016,26(1):47-52.
[6]张春霞,杨丽,王文超.手术治疗分化型甲状腺癌76例临床分析[J].现代肿瘤医学,2016,24(5):724-726.
[7]李翔,刘雪宜,史振超,等.完全腔镜下分化型甲状腺癌根治术的临床应用[J].佛山科学技术学院学报(自然科学版),2016,34(2):72-75.
[8]姚金梅.腔镜下甲状腺癌根治术的围手术期护理[J].中外医疗,2016,35(33):167-169.
[9]王岩,王培顺,李淑琴,等.纳米碳混悬液示踪技术在老年甲状腺乳头状癌中央区淋巴结清扫术中的应用价值[J].中国老年学杂志,2017,37(5):1166-1168.
[10]张娟娟,王少华.纳米碳混悬液在甲状腺微小癌门诊手术中的应用[J].医学研究生学报,2016,29(10):1063-1066.
[11]王新征,李玉梅,刘金彪,等.纳米碳甲状旁腺淋巴负显影技术在甲状腺癌手术中对甲状旁腺功能的保护作用[J].中国实用医药,2016,11(12):48-49.
[12]王玉林,王辉,巴颖.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(B),2016,37(1):38-40.
[13]邓正明,孔凡萍,葛少华,等.纳米碳混悬液在甲状腺癌颈部淋巴结清扫和甲状旁腺保护中的临床应用[J].南京医科大学学报(自然科学版),2016,36(12):1456-1460.
[14]陈泳,单伟颖.纳米碳颗粒显色对甲状旁腺的保护作用[J].中国组织工程研究,2016,20(30):4476-4482.
[15]宋小康,李兴华,毛常青,等.纳米碳甲状旁腺负显影辨认保护技术在甲状腺癌手术中的应用[J].海南医学,2017,28(21):3548-3550.