CAJ | 학술논문

探讨在分化型甲状腺癌（DTC）再手术中应用纳米炭对甲状旁腺保护和引导颈淋巴结清扫的作用与价值。选取2011年2月至2014年2月湖南省人民医院乳腺甲状腺外科116例D T C再手术患者，随机分为观察组（纳米炭组）64例和对照组52例，试验组在术中先向残余甲状腺或癌灶或肿大淋巴结内注射纳米炭0．1ml～0．3ml不等，对照组不使用纳米炭。观察两组辨别甲状旁腺的个数与准确性，以及在颈淋巴结清扫个数的差异。同时观察两组术后常见并发症有无差异。观察组使再手术的D T C患者的甲状旁腺识别率为92．2％，辨别出3个及以上甲状旁腺比率为75％，均明显高于对照组的28．8％、36．5％，两组比较有显著性差异（ P＜0．05）。中央区与侧颈区淋巴结清扫的个数比较，观察组明显多于对照组（P＜0．05）。观察组不增加术后并发症，而且，其一过性的甲状旁腺功能减退的并发症尚有下降趋势（P＜0．05）。纳米炭对DTC再手术中的甲状旁腺的识别率和区域淋巴结的黑染，使甲状旁腺易于识别和保护，有利于更为彻底清扫中央区和侧颈区淋巴结，尚可降低一过性甲状旁腺功能减退的并发症。
탐토재분화형갑상선암（DTC）재수술중응용납미탄대갑상방선보호화인도경림파결청소적작용여개치。선취2011년2월지2014년2월호남성인민의원유선갑상선외과116례D T C재수술환자，수궤분위관찰조（납미탄조）64례화대조조52례，시험조재술중선향잔여갑상선혹암조혹종대림파결내주사납미탄0．1ml～0．3ml불등，대조조불사용납미탄。관찰량조변별갑상방선적개수여준학성，이급재경림파결청소개수적차이。동시관찰량조술후상견병발증유무차이。관찰조사재수술적D T C환자적갑상방선식별솔위92．2％，변별출3개급이상갑상방선비솔위75％，균명현고우대조조적28．8％、36．5％，량조비교유현저성차이（ P＜0．05）。중앙구여측경구림파결청소적개수비교，관찰조명현다우대조조（P＜0．05）。관찰조불증가술후병발증，이차，기일과성적갑상방선공능감퇴적병발증상유하강추세（P＜0．05）。납미탄대DTC재수술중적갑상방선적식별솔화구역림파결적흑염，사갑상방선역우식별화보호，유리우경위철저청소중앙구화측경구림파결，상가강저일과성갑상방선공능감퇴적병발증。
To investigate the role and value of nano carbon suspension in protecting parathyroid gland in reoperation of differentiated thyroid carcinoma surgery .116 cases thyroid carcinoma reoperation patients from 2011 .2 to 2014 .2 in the department of breast and thyroid surgery ,Hunan Provincial People's Hospital were randomly divided into experimental group (carbon nano-group) 64 cases and a control group of 52 patients .In the experimental group during surgery we gave the residual thyroid cancer 0 .1ml~0 .3ml injection of carbon nanoparticles ,while the control group did not use carbon nano-particles .Parathyroid glands and lymph nodes were observed and identified by the differences .In the experimental group ,the reoperation parathyroid negative thyroid cancer developing in the first region Ⅵ lymph nodes in stark contrast to the black developing rate of 92 .2% ,significantly higher than the 28 .8% .There were significant differences .And postoperative transient hypoparathyroidism complications in the experimental group also decreased significantly ( P<0 .05) .In the experimental group ,the percentage of central lymph nodes dissection number equal to or greater than control group ,significantly higher than the 28 .8% and 36 .5% in the contrast .The difference was significant (P< 0 .05) .In thyroid carcinoma reoperation surgery ,Carbon Nanoparticles black dye parathyroid and lymph node negative development , make it not only easy to identify and protect the parathyroid glands and reduces transient hypoparathyroidism complications ,but also conducive to thoroughly clean the central lymph nodes .