摘要
目的 探讨示踪用盐酸米托蒽醌注射液在甲状腺癌根治术中对前哨淋巴结示踪疗效及对甲状旁腺功能保护作用的研究。方法 经术前病理证实为甲状腺乳头状癌(PTC)患者60例,用随机数字表格法分为试验组和对照组,每组30例患者。试验组术中于甲状腺内注射示踪用盐酸米托蒽醌注射液0.6 mL,对照组按常规手术操作。比较2组患者手术前后血钙、甲状旁腺素(PTH)水平以及淋巴结清扫数目。结果 术后第1,3,7,30天,试验组血钙水平分别为(1.97±0.18),(2.09±0.09),(2.11±0.08),(2.18±0.16)mmol·L^(-1),PTH水平为(37.12±17.14),(38.81±16.46),(43.87±17.35),(60.75±18.18)pg·mL^(-1);对照组血钙水平分别为(1.87±0.16),(1.93±0.13),(1.98±0.14),(2.11±0.15)mmol·L^(-1),PTH水平为(25.46±16.83),(26.18±18.05),(34.47±17.35),(56.87±15.82)pg·mL^(-1),术后第1,3,7天指标组间差异均有统计学意义(均P<0.05)。试验组总淋巴结清扫数目和转移淋巴结清扫数目明显高于对照组。试验组术后颜面部麻木、肌肉痉挛、手足抽搐的发生率均显著低于对照组(均P<0.05)。结论 示踪用盐酸米托蒽醌在甲状腺癌手术中有助于辨识甲状旁腺,降低甲状旁腺误切率,减少术后并发症发生,改善患者术后生活质量;增加淋巴结清扫数目及转移淋巴结检出率,降低术后复发风险。
ObjectiveTo evaluate tracing effect of mitoxantrone hydrochloride injection for tracing on sentinel lymph nodes and parathyroid protection in thyroid carcinoma.Methods Sixty patients with thyroid papillary carcinoma (PTC) confirmed by preoperative pathology were randomly divided into treatment group (n=30) and control group (n=30).In treatment group,mitoxantrone hydrochloride injection for tracing 0.6 m L was injected into the thyroid gland,while in the control group,routine operation was performed.The levels of serum calcium,parathyroid hormone (PTH) and the number of lymph node dissection were compared between the two groups pre and post operation.Results On the 1st,3rd,7th and 30th day after operation,the blood calcium levels in treatment group were (1.97±0.18),(2.09±0.09),(2.11±0.08),(2.18±0.16)mmol·L^(-1);the PTH levels were (37.12±17.14),(38.81±16.46),(43.87±17.35),(60.75±18.18) pg·m L^(-1);the blood calcium levels in control group were (1.87±0.16),(1.93±0.13),(1.98±0.14),(2.11±0.15) mmol·L^(-1);the PTH levels were (25.46±16.83),(26.18±18.05),(34.47±17.35),(56.87±15.82) pg·m L^(-1);the differences were statistically significant on 1st,3rd,7th day after operation (all P<0.05).The total number of lymph nodes and metastatic lymph nodes in treatment group were significantly higher than that in control group.The incidence of facial numbness,muscle spasm and extremities spasm and twitch,in treatment group were significantly lower than those in control group (all P<0.05).Conclusion Mitoxantrone hydrochloride injection for tracing is helpful to identify parathyroid gland in thyroid cancer surgery,reduce the rate of misresection of parathyroid gland,reduce postoperative complications,and improve postoperative quality of life of patients.The number of dissected lymph nodes and the detection rate of metastatic lymph nodes were increased to reduce the risk of postoperative recurrence.
作者
顾建华
程宇
于娟
魏晓宇
叶伟
高宇
孙桂森
王毅
GU Jian-hua;CHENG Yu;YU Juan;WEI Xiao-yu;YE Wei;GAO Yu;SUN Gui-sen;WANG Yi(Department of Thyroid,Breast and Hernia Surgery,Tianjin First Central Hospital,Tianjin 300192,China;The Second Department of General Surgery,DagangDistrict Hospital of Tianjin,Tianjin 300270,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2022年第20期2392-2395,共4页
The Chinese Journal of Clinical Pharmacology
基金
北京市健康促进会研究基金资助项目(BJHPA-2022-JZHXZHQNYJ-LCH-12)。
