纳米炭在临床cN0期甲状腺乳头状微小癌预防性中央区淋巴结清扫中的应用价值

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摘要目的探讨纳米炭混悬液在临床颈部淋巴结转移阴性（cN0）期甲状腺乳头状微小癌（PTMC）患者中预防性清扫中央区淋巴结的应用价值。方法选取2017年1月—2019年6月陆军军医大学大坪医院收治的260例cN0期PTMC患者为研究对象，进行回顾性分析。依据术中是否应用纳米炭分为试验组（133例）和对照组（127例）。所有患者均接受甲状腺腺叶及峡部切除，并对患侧中央区淋巴结行预防性清扫，试验组术中应用纳米炭，对照组术中未应用纳米炭。比较两组患者淋巴结清扫数目及转移情况，并进一步分析两组术后甲状旁腺损伤率及暂时性低钙血症和永久性甲状旁腺功能减退等并发症的发生情况。结果试验组平均淋巴结清扫数目、平均淋巴结转移数目和淋巴结转移率均高于对照组（P < 0.05或P < 0.01）。试验组甲状旁腺误切率、暂时性低钙血症率发生低于对照组（P < 0.01）。两组均未发生永久性甲状旁腺功能减退及喉返神经损伤。结论在cN0期PTMC患者预防性行中央区淋巴结清扫中，应用纳米炭能够提高阳性淋巴结的检出率，并且有助于减少甲状旁腺的损伤，降低术后并发症的发生。

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	郝帅赵健洁田武国陈懿罗东林

关键词 ：甲状腺微小乳头状癌, 纳米炭混悬液, 中央区, 淋巴结清扫

Abstract：Objective To investigate the application value of carbon nanoparticle in the prevention of central area lymph node dissection of papillary thyroid microcarcinoma (PTMC) at cN0 stage. Methods From January 2017 to June 2019, a total of 260 PTMC patients with clinical cervical lymph node metastasis negative (cN0) who admitted to Daping Hospital, Army Medical University were selected as study objects. They were divided into experimental group (133 cases) and control group (127 cases), according to whether carbon nanoparticle were used during the operation. All patients underwent hemithyroidectomy and isthmus excision, and preventive central area lymph node dissection was performed. Carbon nanoparticle was used in the experimental group and not in the control group. Lymph node detection and metastasis were compared between the two groups, and the rate of postoperative parathyroid injury and complications such as temporary hypocalcemia and permanent parathyroid hypoparathyroidism were further analyzed. Results The average number of detected lymph node and metastasis in experimental group were higher than those in the control group (P < 0.05 or P < 0.01). The rate of parathyroid mistranslation and incidence of temporary hypocalcemia in the experimental group were lower than those in control group (P < 0.01). There was no permanent hypoparathyroidism or recurrent laryngeal nerve injury in either group. Conclusion In the prevention central area lymph node dissection of cN0 PTMC patients, the application of carbon nanoparticle can improve the detection rate of positive lymph nodes, and help reduce the damage of parathyroid and the occurrence of postoperative complications.

Key words： Papillary thyroid microcarcinoma Carbon nanoparticle suspension Central area Lymph node dissection

基金资助:重庆市科卫联合医学科研项目（2019QNXM027）。

通讯作者: 罗东林（1967-），男，博士，教授；研究方向：甲状腺癌的临床与基础研究。

作者简介: 郝帅（1991-），男，硕士；研究方向：甲状腺癌的临床与基础研究。

引用本文:

郝帅赵健洁田武国陈懿罗东林. 纳米炭在临床cN0期甲状腺乳头状微小癌预防性中央区淋巴结清扫中的应用价值[J]. 中国医药导报, 2021, 18(2): 12-15,26.
HAO Shuai ZHAO Jianjie TIAN Wuguo CHEN Yi LUO Donglin. Application value of carbon nanoparticle in the prevention of central area lymph node dissection of papillary thyroid microcarcinoma at cN0 stage. 中国医药导报, 2021, 18(2): 12-15,26.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2021/V18/I2/12

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