摘要
目的探讨纳米碳示踪在经口腔前庭腔镜甲状腺切除术中的临床效果。方法选取2016年6月至2018年6月我院收治的84例甲状腺乳头状癌患者为研究对象,将其随机分为观察组(44例,经口腔前庭腔镜甲状腺切除术+纳米炭混悬注射液)和对照组(40例,经口腔前庭腔镜甲状腺切除术),比较两组的淋巴结检获数、淋巴结阳性率、甲状旁腺误切数、术后24 h甲状旁腺激素(PTH)水平、喉返神经损伤率及术后低血钙发生率。结果观察组患者的平均淋巴结检获数明显多于对照组(t=3.473,P=0.007);两组患者检出淋巴结的阳性率比较,差异无统计学意义(χ^2=0.427,P=0.513);观察组患者的术后误切甲状旁腺数明显少于对照组(χ^2=3.683,P=0.003);术后24 h,观察组患者的PTH水平明显高于对照组(t=11.300,P=0.000)。术后,观察组出现6例声音嘶哑,对照组出现8例声音嘶哑,差异无统计学意义(χ^2=1.256,P=0.434);术后,观察组出现低钙抽搐0例,显著少于对照组的8例(χ^2=3.764,P=0.005)。结论纳米碳示踪在经口腔前庭腔镜甲状腺切除术中的临床效果显著,可提高中央区淋巴结清扫的彻底性,更好地保护甲状旁腺,有效避免术后低钙的发生。
Objective To explore the clinical effect of nano-carbon tracer in transoral vestibular endoscopic thyroidectomy.Methods A total of 84 patients with papillary thyroid carcinoma admitted in our hospital from June 2016 to June 2018 were randomly divided into observation group(44 cases, transoral vestibular endoscopic thyroidectomy+carbon nanoparticles suspension injection) and control group(40 cases, transoral vestibular endoscopic thyroidectomy). The numbers of lymph nodes detected, the positive rates of lymph nodes, the numbers of misresected parathyroid glands, the levels of parathyroid hormone(PTH) at 24 hours after operation, the rates of recurrent laryngeal nerve injury and the incidences of hypocalcemia were compared between the two groups. Results The average number of lymph nodes detected in the observation group was significantly more than that in the control group(t =3.473, P =0.007). There was no significant difference in the positive detection rates of lymph node between the two groups(χ^2=0.427, P=0.513). The number of misresected parathyroid glands in the observation group was significantly less than that in the control group(χ^2=3.683, P=0.003). At 24 hours after operation,the PTH level in the observation group was significantly higher than that in the control group(t=11.300, P=0.000). After operation, there were 6 cases of hoarseness in the observation group and 8 cases in the control group, and there was no significant difference between the two groups(χ^2=1.256, P =0.434). After operation, there was 0 cases of hypocalcemia convulsions in the observation group, which was significantly less than 8 cases in the control group(χ^2=3.764, P =0.005).Conclusion Nano-carbon tracer in transoral vestibular endoscopic thyroidectomy has a significant effect, which can improve the thoroughness of lymph node dissection in central area, better protect parathyroid gland and effectively avoid the occurrence of hypocalcemia after operation.
作者
惠栓
徐子忠
HUI Shuan;XU Zi-zhong(the First People's Hospital of Xianyang,Xianyang 712000,China)
出处
《临床医学研究与实践》
2019年第27期62-64,共3页
Clinical Research and Practice
关键词
纳米碳
甲状腺癌
甲状旁腺
nano-carbon
thyroid carcinoma
parathyroid glands
