文章摘要
刘利敏,陈勇,张琰,徐宙,陆宝华,陈翔.纳米碳在cN0期单侧甲状腺乳头状癌行双侧中央区淋巴结清扫中的临床应用[J].中国医药导刊,2019,21(6):321-324.
纳米碳在cN0期单侧甲状腺乳头状癌行双侧中央区淋巴结清扫中的临床应用
The Clinical Application of Carbon Nanoparticles in Bilateral Central Lymph Node Dissection of Unilateral Papillary Thyroid Carcinoma in the Phase of cN0
投稿时间:2019-05-05  修订日期:2019-05-30
DOI:
中文关键词: 甲状腺乳头状癌  甲状旁腺  喉返神经  纳米碳混悬液  中央区清扫
英文关键词: Papillary thyroid carcinoma  Parathyroid  Recurrent laryngeal nerve  Carbon nanoparticles suspension  Central lymph node dissection
基金项目:上海市宝山区科学技术委员会科技创新专项资金项目(项目编号:18-E-8;项目名称:KLF4通过调节Wnt信号通路抑制甲状腺癌上皮-间质转化和侵袭转移的机制研究)
作者单位E-mail
刘利敏 上海市宝山区中西医结合医院 甲状腺外科 lm-liu@163.com 
陈勇 上海市宝山区中西医结合医院 甲状腺外科  
张琰 上海市宝山区中西医结合医院 甲状腺外科  
徐宙 上海市宝山区中西医结合医院 甲状腺外科  
陆宝华 上海市宝山区中西医结合医院 甲状腺外科  
陈翔 上海市宝山区中西医结合医院 甲状腺外科 chen???_xiang8@126.com 
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中文摘要:
      目的:探讨纳米碳在cN0期单侧甲状腺乳头状癌行双侧中央区淋巴结清扫中的临床应用价值。方法:选择我院2016年1月至2019年1月cN0期单侧甲状腺乳头状癌首次手术患者100例,分为对照组(n=50例)和实验组(n=50例),实验组辅以纳米碳显影,行患侧甲状腺腺叶+峡部+双侧中央区淋巴结清扫术,对照组行患侧甲状腺腺叶+峡部+同侧中央区淋巴结清扫。分析两组患者手术时间、术中出血量、术后引流量、住院时间、住院费用、术后1 d血钙及术后6个月的血钙及甲状旁腺素、术后声嘶、甲状旁腺误切等情况。结果:两组患者术中出血量、术后引流量、住院时间、住院费用、术后6个月血钙及血甲状旁腺素比较,差异均无统计学意义(P>0.05);实验组术后第1天血钙、术后甲状旁腺误切数低于对照组,差异有统计学意义(P<0.05),实验组手术时间、中央区淋巴结清扫数及患侧阳性数、暂时性术后声嘶率高于对照组,两组比较差异均有统计学意义(P<0.05)。结论:cN0期单侧甲状腺乳头状癌应积极行双侧中央区淋巴结清扫,辅以纳米碳显影能提高淋巴结的检出率及阳性率,防止甲状旁腺与喉返神经损伤,手术安全可靠。
英文摘要:
      Objective: To investigate the clinical value of carbon nanoparticles in bilateral central lymph node dissection of unilateral papillary thyroid carcinoma (cN0 phase). Methods: A total of 100 patients with unilateral papillary thyroid carcinoma in the phase of cN0 were divided into two groups, the control group (n=50) and the experimental group (n=50), from January 2016 to January 2019. The experimental group applied carbon nanoparticles in the surgery. The thyroid gland lobe and isthmus and bilateral central area lymph node dissection was performed in the experimental group. The thyroid gland lobe and isthmus and ipsilateral central area lymph node dissection was performed in the control group. The operative time, intraoperative bleeding volume, postoperative drainage volume, hospitalization time, hospitalization cost, serum calcium 1 d after operation and 6 months after operation, parathyroid hormone levels, hoarseness after operation, misresection of parathyroid were analyzed. Results: There was no significant difference between the two groups in intraoperative bleeding volume, postoperative drainage volume, postoperative hospitalization time, hospitalization cost, serum calcium 6 months after operation and serum parathyroid hormone level(P>0.05). The serum calcium 1 d after operation and misresection of parathyroid in the experimental group were lower than those in the control group, which had statistical difference (P<0.05). The operation time, number of lymph nodes detected, positive number of the affected side in the central area and the temporary hoarseness after operation in the experimental group were higher than those in the control group, which had statistical difference(P<0.05).Conclusion: Bilateral central lymph node dissection should be performed in unilateral cN0 stage papillary thyroid carcinoma. Combined with carbon nanoparticles imaging, the detection rate and positive rate of lymph nodes can be increased, parathyroid and recurrent laryngeal nerve injury can be prevented, which is safe and reliable.
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