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Application of carbon nano-particles in total thyroidectomy combined with lymphadenectomy in area Ⅵ

Application of carbon nano-particles in total thyroidectomy combined with lymphadenectomy in area Ⅵ

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 54(1): 28-32

目的: 探讨在甲状腺乳头状癌全切联合Ⅵ区淋巴清扫术中应用纳米碳混悬注射液对甲状旁腺保护及淋巴清扫的作用。 方法: 回顾性分析南京医科大学附属肿瘤医院头颈外科2016年4月至2018年1月完成的194例接受甲状腺全切+Ⅵ区淋巴清扫术的甲状腺乳头状癌患者,其中术中应用纳米碳的作为纳米碳组104例,常规手术的作为对照组90例。比较两组患者Ⅵ区及右侧Ⅵb区淋巴清扫数量、转移淋巴结数、术后(1 d、3 d、1个月及6个月)低钙血症及甲状旁腺功能减退发生率以及甲状旁腺误切率。采用卡方和秩和检验对数据进行分析。 结果: 两组患者在年龄、性别、肿瘤大小、手术时间、肿瘤是否外侵以及是否多灶等方面比较差异无统计学意义,两组患者出现暂时性甲状旁腺功能减退的例数分别为纳米碳组28例(26.9%),对照组41例(45.5%),差异有统计学意义(χ(2)=7.3,P=0.007),纳米碳组出现2例(1.9%)甲状旁腺误切,对照组出现8例(8.9%)甲状旁腺误切,差异有统计学意义(χ(2)=4.9,P=0.026)。两组清扫出的Ⅵ区淋巴结枚数分别为791枚和536枚(Z=-2.2,P=0.028),右侧Ⅵb区淋巴结枚数分别为93枚和41枚(Z=-2.1,P=0.034),差异均有统计学意义。 结论: 纳米碳在甲状腺乳头状癌甲状腺全切联合Ⅵ区淋巴清扫术中可以有效辨识及保护甲状旁腺,预防术后甲状旁腺功能低下的发生,并提高Ⅵ区淋巴结的清扫效果。.

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Accession: 066446291

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PMID: 30704166

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