文章摘要
汤维芳,王圣应.纳米炭在甲状腺乳头状癌联合根治术中的应用价值[J].中国临床保健杂志,2018,21(5):686-688.
纳米炭在甲状腺乳头状癌联合根治术中的应用价值
The clinical value of carbon nanoparticles in treatment of papillary thyroid cancer undergoing thyroidectomy with central neck dissection
投稿时间:2018-07-17  
DOI:10.3969/J.issn.1672-6790.2018.05.031
中文关键词: 甲状腺肿瘤  癌,乳头状  纳米粒子,碳  指示剂和试剂
英文关键词: Thyroid neoplasms  Carcinoma,papillary  Nanoparticles,carbon  Indicators and reagents 〖FL
基金项目:安徽省自然基金项目(1508085QH183)
作者单位E-mail
汤维芳 中国科学技术大学附属第一医院西区安徽省肿瘤医院头颈乳腺外科,合肥 230031 wangshengying61@163.com 
王圣应 中国科学技术大学附属第一医院西区安徽省肿瘤医院头颈乳腺外科,合肥 230031 wangshengying61@163.com 
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中文摘要:
      目的 探索纳米炭在甲状腺癌手术中的应用价值。方法 收集216例甲状腺乳头状癌患者的临床病理学资料。使用纳米炭混悬液组(纳米炭组)和未使用纳米炭混悬液组(对照组)各108例。比较两组患者的基线特征(年龄、性别、原发灶最大直径、T分期、包膜侵犯、双侧癌、手术方式)、淋巴结清扫数、淋巴结转移情况以及术前、术后甲状旁腺功能指标和术后并发症等相关指标。结果 两组患者在年龄、性别、原发灶最大直径、T分期、包膜侵犯、双侧癌、手术方式等基线特征方面差异无统计学意义(P>0.05)。纳米炭组平均清扫(11.4±5.3)枚,多于对照组的(6.3±4.1)枚(P<0.05)。纳米炭组平均阳性淋巴结数为(2.4±3.6)枚,同样多于对照组的(1.0±1.7)枚(P<0.05)。纳米炭组甲状旁腺功能保护方面,两组患者手术前后甲状旁腺激素(PTH)和血钙值在组间、时间及交互作用的整体分析中差异均有统计学意义(均P<0.05);纳米炭组在术后4个时间点上,尤其是术后1个月和3个月的PTH值和血钙值均明显高于对照组(P<0.05);且术后纳米炭组一过性低血钙症状7例,对照组18例,两组差异有统计学意义(P<0.05)。结论 纳米炭可以增加中央区淋巴结清扫数目及转移淋巴结的切除率,且降低了甲状旁腺暂时性损伤的风险,对术中、术后甲状旁腺功能的保护起到了一定的作用。
英文摘要:
      Objective To investigate the clinical significance of the carbon nanoparticles(CN) in treatment of papillary thyroid cancer undergoing thyroidectomy with neck dissection.Methods A total of 216 patients enrolled in our study and allocated to the control group(n=108) and the CN group(n=108).All the patients have received (near) total unilateral lobectomy or bilateral thyroidectomy plus the central neck dissection.The baseline characteristics,lymph node-related indices (including number of total dissected lymph nodes and metastatic lymph nodes at central area),parathyroid hormone levels and postoperative complication indices were collected and compared between the 2 groups.Results The differences of baseline characteristics between the CN group and the control group were not significant (all P>0.05).The total dissected lymph nodes in the CN group are 1231 while the control group are 682.The average lymph nodes in each patients in the CN group were 11.4±5.3 which is higher than 6.3±4.1 of the control group(P<0.05).And similarly in the CN group,the average counts of positive lymph nodes was also higher than the control group[(2.4±3.6) vs (1.0±1.7)](P<0.05).In the integral analysis,the differences between the two groups of parathyroid hormone and serum calcium before and after surgery were all statistically significant (all P<0.05).And in the Intergroup comparison,the mean parathyroid hormone levels and average serum calcium in the CN group were all higher than the control group at the four time points,especially at 1 and 3 months after operation(all P<0.05).There were 7 patients with transient hypocalcaemia in the CN group while 18 patients in the control group(P<0.05).Conclusion The CN can increase the total retrieved lymph nodes in central neck dissection and the rate of metastatic lymph nodes resection.It also may decrease the risk of transient parathyroid injury.So the CN is clinically valuable in treatment of papillary thyroid cancer undergoing thyroidectomy with neck dissection.
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