CAJ | 학술논문

目的：探讨术前超声引导下甲状腺纳米碳注射对甲状腺癌颈部淋巴结清扫的指导意义。方法①58例初治甲状腺癌的患者随机分为纳米碳组和对照组。纳米碳组术前1d在超声引导下行甲状腺内纳米碳注射，术中进行患侧甲状腺切除，若术中病理诊断为甲状腺癌，则进行甲状腺全切+中央区颈淋巴清扫+患侧侧颈区淋巴结清扫术。对照组不做术前纳米碳注射，直接行手术。②分别计数纳米碳组及对照组清除淋巴结总数量，并以直径为5mm为标准，将检出的淋巴结分为>5mm及<5mm两组，并进行分析。结果①纳米碳组中淋巴结黑染率为97.5％。纳米碳组淋巴结检出数量多于对照组，两组差异有统计学意义（P<0.05）；②以直径5mm为标准，将淋巴结划归两类，纳米碳组中直径<5mm的淋巴结检出个数明显高于对照组，两者具有统计学差异（P<0.01）。而对于直径>5mm的淋巴结，虽然纳米碳组中检出个数多于对照组，但两者之间无统计学差异（P>0.05）。结论①术前超声引导下甲状腺纳米碳注射是纳米碳甲状腺内注射的一种有效、方便、可行的方法；②纳米碳可使甲状腺引流区域淋巴结黑染，在手术中只需切除黑染组织即可保证淋巴清扫的彻底性；③纳米碳可提高淋巴结检出个数，特别是直径<5mm的淋巴结，为术后个体化治疗提供更详细的依据。
목적：탐토술전초성인도하갑상선납미탄주사대갑상선암경부림파결청소적지도의의。방법①58례초치갑상선암적환자수궤분위납미탄조화대조조。납미탄조술전1d재초성인도하행갑상선내납미탄주사，술중진행환측갑상선절제，약술중병리진단위갑상선암，칙진행갑상선전절+중앙구경림파청소+환측측경구림파결청소술。대조조불주술전납미탄주사，직접행수술。②분별계수납미탄조급대조조청제림파결총수량，병이직경위5mm위표준，장검출적림파결분위>5mm급<5mm량조，병진행분석。결과①납미탄조중림파결흑염솔위97.5％。납미탄조림파결검출수량다우대조조，량조차이유통계학의의（P<0.05）；②이직경5mm위표준，장림파결화귀량류，납미탄조중직경<5mm적림파결검출개수명현고우대조조，량자구유통계학차이（P<0.01）。이대우직경>5mm적림파결，수연납미탄조중검출개수다우대조조，단량자지간무통계학차이（P>0.05）。결론①술전초성인도하갑상선납미탄주사시납미탄갑상선내주사적일충유효、방편、가행적방법；②납미탄가사갑상선인류구역림파결흑염，재수술중지수절제흑염조직즉가보증림파청소적철저성；③납미탄가제고림파결검출개수，특별시직경<5mm적림파결，위술후개체화치료제공경상세적의거。
Objective To evaluate the ef ect of preoperative carbon nanoparticles thyroid injection under ultrasound guidance on cervical lymph nodes dissection. Methods 58 clinical y diagnosed thyroid cancer patients were randomly divided into 2 groups: carbon nanoparticles group and control group. Carbon nanoparticles were injected into the thyroid under ultrasound guidance one day before surgery. Patient underwent lateral thyroidectomy.If intraoperative frozen pathological y diagnosed as thyroid cancer, total thyroidectomy and lymph node dissection was conducted. The control group was directly underwent operation. The number of the total lymph nodes dissected was analyzed. And the diameters (>5mm or <5mm) of the dissected lymph nodes were also analyzed. Results 97.5%dissected lymph nodes were wel carbon narnoparticle stained. The amount of lymph nodes during cervical lymph nodes dissection in the carbon nanoparticles group was significantly higher than control(p<0.05). The amount of smal er lymph nodes which were<5mm in carbon nanoparticle group was significantly higher than control (p<0.01), while those>5mm lymph nodes showed no significant dif erence between the two groups. Conclusions Preoperative ultrasound guided carbon nanoparticles thyroid injection is an ef ective method, and it contributed to lymph nodes' pick-out, especial y those<5mm in diameter during cervical lymph node dissection.