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目的探讨纳米碳淋巴示踪剂在甲状腺癌手术中的应用对甲状旁腺保护的作用。方法收集2014年6月~2015年3月于潍坊市人民医院乳腺外科甲状腺癌患者中术中应用纳米碳混悬液17例作为研究组,随机选取常规手术者20例作为对照组,研究组在注射纳米碳混悬液30min后清扫中央区淋巴结,对照组直接清扫中央区淋巴结。统计术后病理检查中研究组黑染组织、非黑染组织及对照组中淋巴结个数及转移数并检查有无甲状旁腺成分,分析两组有无统计学差异。结果研究组黑染组织、非黑染组织和对照组分别发现淋巴结数为147个、7个、95个,淋巴结转移数分别为91个、1个、57个,检测到甲状旁腺数分别为0个、1个、6个。黑染组织中淋巴结清扫数比对照组多(P<0.05)。纳米碳的淋巴结黑染率为95.5%,黑染组织未查见甲状旁腺组织。结论纳米碳在甲状腺癌术中可助于甲状旁腺的分辨及淋巴结清扫,示踪效果明显,有助于对甲状旁腺的保护。
Objective To investigate the effect of nanocarbon lymphatic tracer on parathyroid gland protection in thyroid cancer surgery. Methods 17 patients with thyroid cancer who underwent thyroidectomy in Department of Breast Surgery, Weifang People’s Hospital from June 2014 to March 2015 were selected as research group and 20 patients were randomly selected as control group. After 30min injection of nanocarbon suspension, the central lymph nodes were dissected and the control group directly dissected the central lymph nodes. The number of lymph nodes and the number of metastases in the black group, the non-black group and the control group in the study group were counted and the presence or absence of parathyroid gland was examined. The difference between the two groups was analyzed. Results The numbers of lymph nodes in study group were 147, 7 and 95 respectively, the number of lymph node metastasis was 91, 1 and 57, respectively. The number of detected parathyroid gland were 0, 1, 6. The number of lymph node dissection in black dye group was more than that in control group (P <0.05). Nano-carbon black lymph node staining rate was 95.5%, black stained tissue did not check the parathyroid tissue. Conclusion Nano-carbon in thyroid cancer surgery can help parathyroid differentiation and lymph node dissection, tracing effect is obvious, contribute to the protection of the parathyroid.