摘要
目的探讨纳米炭与吲哚箐绿(indocyanine green,ICG)荧光两种示踪法对甲状腺微小乳头状癌术中淋巴结清扫和甲状旁腺保护作用的效果。方法纳入2017年3月至2019年1月在本院头颈外科行甲状腺微小乳头状癌根治术的患者103例,随机分为纳米炭组(53例)和ICG组(50例);纳米炭组在术中向甲状腺组织中注射纳米炭混悬液引导淋巴结清扫,ICG组术中向甲状腺组织注射吲哚箐绿示踪剂引导淋巴结清扫;比较两组患者手术指标,获取淋巴结总数、不同大小淋巴结数目、淋巴结转移检出率,甲状旁腺检出率、术后甲状旁腺素(PTH)、钙离子(Ca2+)水平、暂时性低钙血症和暂时性甲状旁腺功能减退率,记录两组患者术后并发症发生情况。结果两组患者在手术时间、术中出血量、术后引流量、术后住院时间方面比较差异无统计学意义(P>0.05);纳米炭组在获取淋巴结总数、<0.5 cm淋巴结获取数目及淋巴结转移检出率方面高于ICG组,差异具有统计学意义(P<0.05);纳米炭组在甲状旁腺检出率、暂时性低钙血症发生率低于ICG组,且术后PTH、Ca2+水平高于ICG组,差异具有统计学意义(P<0.05);两组患者发生喉返神经损伤、切口感染、皮下积血/积液及胸导管损伤等并发症情况比较差异无统计学意义(P>0.05)。结论与ICG示踪法相比,纳米炭示踪法在甲状腺癌术中能够提高淋巴结清扫程度,有效保护甲状旁腺不受损伤,安全可靠。
Objective To compare the effects of two carbon and indocyanine green(ICG)fluorescence tracer methods on lymph node dissection and thyroid protection in thyroid carcinoma.Methods A total of 103 patients who underwent radical thyroidectomy in our Hospital from March,2017 to January,2019 were randomly divided into a nanocarbon group(53 cases)and an ICG group(50 cases).In the nanocarbon group,the nanocarbon suspension was injected into the thyroid tissue to guide the lymph node dissection.In the ICG group,the thyroid tissue was injected with the indocyanine green tracer to guide the lymph node dissection.The surgical indexes of the two groups were then compared to obtain the total number of lymph nodes,the number of lymph nodes of different sizes,the detection rate of lymph node metastasis,the detection rate of parathyroid,postoperative parathyroid hormone(PTH),calciumion(Ca2+)level,and temporary low calcium rate,as well as hemorrhage and transient hypoparathyroidism rate.The postoperative complications were recorded in both groups.Results There was no significant difference in the operation time,intraoperative blood loss,postoperative drainage,and postoperative hospital stay between the two patients(P>0.05).The number of lymph nodes in the nanocarbon group was higher than that in the ICG group,including the total number of acquired lymph nodes,the number of lymph node acquisitions less than 0.5cm,and the detection rate of lymph node metastasis(P<0.05).The detection rate of parathyroid gland and the incidence of transient hypocalcemia in the nanocarbon group were lower than those in the ICG group,and the postoperative PTH and Ca2+levels were higher than those in the ICG group(P<0.05).There were no significant differences in complications such as recurrent laryngeal nerve injury,wound infection,subcutaneous hemorrhage/effusion and thoracic duct between the two groups(P>0.05).Conclusion Nanocarbon tracer can improve the degree of lymph node dissection in thyroid cancer surgery,and effectively protect the parathyroid gl
作者
尚兴国
张雪棉
岳秀杰
孙晋发
徐凯
SHANG Xingguo;ZHANG Xuemian;YUE Xiujie;SUN Jinfa;XU Kai(Department of Head and Neck Surgery, Fourth Hospital of Qinhuangdao, Qinhuangdao 066000, China;Department of Ultrasonography, Third Hospital of Qinhuangdao, Qinhuangdao 066000, China;Department of Pathology, Fourth Hospital of Qinhuangdao City, Qinhuangdao 066000, China)
出处
《标记免疫分析与临床》
CAS
2020年第3期423-427,431,共6页
Labeled Immunoassays and Clinical Medicine
基金
秦皇岛市市级科技计划项目(编号:201805A029)。
关键词
纳米炭
吲哚箐绿
甲状腺癌
淋巴结清扫
甲状旁腺
Nanocarbon
Indocyanine green
Thyroid cancer
Lymph node dissection
Parathyroid gland
