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活性纳米碳在T1期甲状腺乳头状非微小癌预防性中央区淋巴结清扫术中的应用
引用本文:龙淼云,龙宏阳,黄明清,彭新治,罗定远,黄楷,黎洪浩.活性纳米碳在T1期甲状腺乳头状非微小癌预防性中央区淋巴结清扫术中的应用[J].内分泌外科杂志,2014,8(5):422-424.
作者姓名:龙淼云  龙宏阳  黄明清  彭新治  罗定远  黄楷  黎洪浩
作者单位:1. 中山大学孙逸仙纪念医院甲状腺外科, 广州,510120
2. 519000,珠海市香洲区人民医院检验科
摘    要:目的 探讨活性纳米碳在T1期甲状腺乳头状非微小癌行预防性中央区淋巴结清扫术中的作用.方法 将中山大学孙逸仙纪念医院甲状腺外科2012年1月至2013年6月进行手术的甲状腺癌患者,术前均经细胞穿刺确诊为T1期甲状腺乳头状非微小癌,按手术顺序的单双号分2组.单号为实验组,双号组为对照组,实验组在患侧甲状腺注射活性纳米碳.观察2组术后淋巴转移、甲状旁腺功能及喉返神经损伤性声嘶的发生率.结果 实验组切除的淋巴结总数量为327枚,对照组为238枚;实验组及对照组阳性的淋巴结分别为120(36.7%)及56(23.5%)枚,差异有统计学意义(P =0.000 85);实验组及对照组发生淋巴转移的患者数及百分率分别为42(56%)及30(40%),差异有统计学意义(P =0.049 9);实验组及对照组平均每个患者阳性淋巴数量分别为(2.86±0.13)及(1.87±0.09)个,差异有统计学意义(P=0.009).实验组及对照组术后暂时性甲状旁腺功能低下发生率分别为34.7%及60%,差异有统计学意义(P=0.002).实验组及对照组术后声嘶发生率分别为2.7%及4%,差异无统计学意义(P=1.000).结论 活性纳米碳可在T1期甲状腺乳头状非微小癌的预防性淋巴结清扫术中起重要作用,不仅有助于阳性淋巴结的清扫,还能避免甲状旁腺的误切,但无助于降低术中喉返神经损伤的发生率.

关 键 词:甲状腺癌  预防性淋巴清扫术  活性纳米碳

Activated nano carbon in prophylactic central lymph node dissection of T1 papillary thyroid non-microcarcinoma
Authors:Long Miaoyun  Long Hongyang  Huang Mingqing  Peng Xinzhi  Luo Dingyuan  Huang Kai  Li Honghao
Institution:Long Miaoyun,Long Hongyang Huang Mingqing,Peng Xinzhi,Luo Dingyuan,Huang Kai,Li Honghao( 1.Department of Thyroid Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510120, China;)
Abstract:Objective To investigate activated nano carbon in prophylactic central lymph node dissection of T1 papillary thyroid non-microcarcinoma.Methods Patients with T1 papillary thyroid non-microcarcinoma in Thyroid Surgery Department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University undergoing surgery from Jan.2012 to Jun.2013 were divided into 2 groups:odd numbers were the experimental group,and even numbers were the control group.Activated nano carbon was injected in the affected side of the thyroid in the experimental group.The lymph node metastasis,parathyroid function,and the rate of recurrent laryngeal nerve (RLN) injury were compared between the 2 groups.Results The total number of resected lymph nodes in the experimental group and the control group were 327 and 238 respectively.The positive lymph nodes in the experimental group and the control group were 120 (36.7%)and 56 (23.5 %)respectively.The difference had statistical significance (P =0.000 85).The number of patients with lymphatic metastasis in the experimental group and the control group was 42 (56%) and 30 (40%) respectively.The difference had statistical significance (P =0.049 9).The average number of positive lymph node for patients in the experimental group and the control group was (2.86 ± 0.13) and(1.87 ± 0.09) respectively.The difference had statistical significance(P =0.009).The rate of transient hypoparathyroidism in the experimental group and the control group was 34.7% and 60% respectively.The difference had statistical significance (P =0.002).The incidence of hoarseness caused by RLN injury was 2.7% and 4% respectively in the experimental group and the control group.The difference had no statistical significance(P =1.000).Conclusions Activated nano carbon plays an important role in prophylactic central lymph node dissection of T1 papillary thyroid non-microcarcinoma phase.It not only contributes to lymph node dissection,but also protects parathyroid.However,it can'
Keywords:Papillary thyroid carcinoma  Prophylactic central lymph node dissection  Activated nano carbon
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