CAJ | 학술논문

目的：探讨在甲状腺癌手术中采用纳米碳淋巴示踪剂保护甲状旁腺的作用。方法回顾性分析我院2014年1月至10月收治的65例甲状腺癌患者的临床资料,按是否在甲状腺内注射纳米碳分成2组,实验组30例患者操作开始前在甲状腺内注射纳米碳,对照组35例未注射纳米碳,实验组行甲状腺患侧腺叶+峡叶+对侧腺叶次全切除术22例,行双侧甲状腺全切除术8例,对照组行甲状腺患侧腺叶+峡叶+对侧腺叶次全切除术25例,行双侧甲状腺全切除术10例。2组患者均联合中央区淋巴结清扫术。结果纳米碳可使中央区淋巴结黑染,而甲状旁腺不黑染。实验组每例显露(2.6±0.8)枚甲状旁腺,误切0枚；对照组每例显露(1.9±0.7)枚甲状旁腺,误切3枚,2组之间差异有统计学意义(P<0.05)。2组患者均未发生永久性甲状旁腺功能低下,实验组有1例暂时性甲状旁腺功能低下,对照组有2例甲状旁腺功能低下,差异无统计学意义。结论纳米碳混悬液有利于术中甲状旁腺的识别,降低甲状旁腺误切率,但不能降低术后甲状旁腺功能低下的发生率。
목적：탐토재갑상선암수술중채용납미탄림파시종제보호갑상방선적작용。방법회고성분석아원2014년1월지10월수치적65례갑상선암환자적림상자료,안시부재갑상선내주사납미탄분성2조,실험조30례환자조작개시전재갑상선내주사납미탄,대조조35례미주사납미탄,실험조행갑상선환측선협+협협+대측선협차전절제술22례,행쌍측갑상선전절제술8례,대조조행갑상선환측선협+협협+대측선협차전절제술25례,행쌍측갑상선전절제술10례。2조환자균연합중앙구림파결청소술。결과납미탄가사중앙구림파결흑염,이갑상방선불흑염。실험조매례현로(2.6±0.8)매갑상방선,오절0매；대조조매례현로(1.9±0.7)매갑상방선,오절3매,2조지간차이유통계학의의(P<0.05)。2조환자균미발생영구성갑상방선공능저하,실험조유1례잠시성갑상방선공능저하,대조조유2례갑상방선공능저하,차이무통계학의의。결론납미탄혼현액유리우술중갑상방선적식별,강저갑상방선오절솔,단불능강저술후갑상방선공능저하적발생솔。
Objective To discuss the protective effect of carbon nanoparticles lymphatic tracer on parathyroid glands in the operation of thyroid carcinoma. Methods Retrospectively analyzed the clinical data of 65 thyroid carcinoma patients from January 2014 to October 2014, and they were divided into 2 groups according to whether injected with carbon nanoparticles. The experimental group (30 cases) were injected with carbon nanoparticles in thyroidglands before major procedure, while the control group (35 cases) were not injected. In the experimental group, there were 22 cases accepted total thyroidectomy of the affected side gland + isthmus thyroidectomy + subtotal thyroidectomy of the offside gland, and 8 cases of total thyroidectomy. In the control group, there were 25 cases accepted total thyroidectomy of the affected side gland + isthmus thyroidectomy + subtotal thyroidectomy of the offside gland,and 10 cases of total thyroidectomy. And all the 65 cases ac-cepted centrallymph nodes dissection. Results After carbon nanoparticles injection, central lymph nodes became black while parathyroid glands did not become black. The experimental group showed (2. 6 ± 0. 8) parathyroids each patient, and no parathyroid was cut by mis-take;the control group showed (1. 9 ± 0. 7) parathyroids each patient, and 3 parathyroids were cut by mistake. and the difference between the two groups was statistical meaningful (P<0. 05). There was no permanent hypoparathyroidism in the two groups. There was 1 cases of temporary hypoparathyroidism occured in the experimental group, and 3 cases occured in the control group, and there was no statistical sig-nificance difference between the two groups. Conclusion Carbon nanoparticles is benefit to the identification of parathyroid in surgery, and it can reduce the incidence of inadvertent parathyroidectomy, but it cann’ t reduce the incidence of hypoparathyroidism after procedure.