术前超声引导下注射纳米炭在PTC全切除手术中临床应用价值

Clinical Application Value of Preoperative Ultrasound-Guided Injection of Carbon Nanoparticles in Total Resection of PTC

摘要: 目的：探讨术前超声引导下向腺体内注射纳米炭在甲状腺乳头状癌全切除手术中的应用价值。方法：收集我院接受甲状腺全切除 中央区淋巴结清扫术的80例甲状腺乳头状癌患者，随机将其分为实验组40例，和对照组40例。实验组采用术前24小时在超声引导下将纳米炭注射到甲状腺腺体内，对照组采用术中直视下注射纳米炭到甲状腺腺体内。比较两组患者术中淋巴结清扫数目、淋巴结黑染数目、手术时间、出血量以及并发症发生率等差异。结果：实验组：实验组患者淋巴结黑染数目更多、淋巴结清扫更彻底，手术时间更短、出血量更少以及并发症发生率更低，各项指标明显优于对照组(P < 0.05)。结论：与术中直视下注射纳米炭相比，术前超声引导下注射纳米炭可帮助术者降低PTC术中淋巴结的漏检率，提高淋巴结清扫的彻底性，降低并发症发生率，减少术后复发和转移率，提高临床疗效的辅助治疗方法。

Abstract: Objective: To evaluate the value of preoperative ultrasound-guided injection of carbon nanoparticles into the gland in total resection of papillary thyroid carcinoma. Methods: A total of 80 patients with papillary thyroid carcinoma who underwent total thyroidectomy plus central lymph node dissection were collected and randomly divided into experimental group (40 cases) and control group (40 cases). In the experimental group, carbon nanoparticles were injected into the thyroid gland 24 hours before surgery under the guidance of ultrasound, while in the control group, carbon nanoparticles were injected into the thyroid gland under direct vision during the operation. The number of lymph node dissection, the number of lymph node black stain, the operation time, the amount of blood loss and the incidence of complications were compared between the two groups. Results: Experimental group: The experimental group had more lymph node black staining, more thorough lymph node dissection, shorter operation time, less blood loss and lower complication rate, and all indexes were significantly better than control group (P < 0.05). Conclusion: Compared with direct injection of carbon nanoparticles during the operation, ultrasound guided injection of carbon nanoparticles before the operation can help the operators to reduce the missed rate of lymph nodes during PTC operation, improve the thoroughness of lymph node dissection, reduce the incidence of complications, reduce the rate of postoperative recurrence and metastasis, and improve the adjuvant treatment of clinical efficacy.