CAJ | 학술논문

目的：探讨术前胃镜下注射与术中注射纳米碳淋巴示踪剂在胃癌根治术中的应用价值。方法选择2013年5月—2015年4月行胃癌D2根治术患者86例，按照注射纳米碳淋巴示踪剂的时机不同，分为术前组（40例）以及术中组（46例），术前组于术前24 h在胃镜下行胃黏膜下注射纳米碳混悬液1 ml，术中组于术中行胃浆膜下注射纳米碳混悬液1 ml，比较2组淋巴结检获情况及淋巴结黑染情况。结果术前组平均淋巴结检出数、D2淋巴结检出数以及直径≤5 mm的淋巴结检出数显著多于术中组（ P ＜0…．05），平均淋巴结检出时间显著短于术中组（ P ＜0．05），D2淋巴结黑染数显著多于术中组（ P ＜0．05），而D1淋巴结平均检出数以及黑染数无显著性差异（ P ＞0．05）。结论术前胃镜下注射纳米碳淋巴示踪剂能有助于显色淋巴结，提高淋巴结检出率；缩短淋巴结清扫时间，有助于检出直径较小的淋巴结。
목적：탐토술전위경하주사여술중주사납미탄림파시종제재위암근치술중적응용개치。방법선택2013년5월—2015년4월행위암D2근치술환자86례，안조주사납미탄림파시종제적시궤불동，분위술전조（40례）이급술중조（46례），술전조우술전24 h재위경하행위점막하주사납미탄혼현액1 ml，술중조우술중행위장막하주사납미탄혼현액1 ml，비교2조림파결검획정황급림파결흑염정황。결과술전조평균림파결검출수、D2림파결검출수이급직경≤5 mm적림파결검출수현저다우술중조（ P ＜0…．05），평균림파결검출시간현저단우술중조（ P ＜0．05），D2림파결흑염수현저다우술중조（ P ＜0．05），이D1림파결평균검출수이급흑염수무현저성차이（ P ＞0．05）。결론술전위경하주사납미탄림파시종제능유조우현색림파결，제고림파결검출솔；축단림파결청소시간，유조우검출직경교소적림파결。
Objective To investigate the application value of nanocarbon lymphatic tracer in the treatment of gastric cancer by preoperative endoscopic injection .Methods From May 2013 to April 2015, 86 patients underwent D2 radical were enrolled, according to the different timing of injection of nanocarbon lymph tracer , they were divided into the preoperative group (40 cases) and operation group (46 cases), preoperative group at preoperative 24 h were injected nanocarbon suspen-sion 1 ml through endoscopic gastric mucosal , operation group during operation performed the gastric subserosal injection of nanocarbon mixed suspension 1 ml, compared the lymph examination and lymph black staining between the 2 groups.Results The preoperative group ’ s average detection of lymph node number , D2 lymph node detection number and diameter equal or less than 5 mm’s lymph nodes detection were significantly higher than that of the operation group ( P <0.05), the mean lymph node detection time was significantly shorter in the operation group ( P <0.05) and D2 lymph nodes black staining number was significantly higher than that in the operation group ( P <0.05), and D1 lymph node average detection and black straining revealed no significant differences ( P >0.05).Conclusion Preoperative endoscopic injection of nanocarbon lymph tracer can contribute to the lymph node staining and improve the detection of lymph node ;shorten the lymph node dissection time, and help to detect of the smaller lymph node .