术前超声引导下甲状腺内注射纳米碳颗粒在甲状腺乳头状癌中央区淋巴结清扫中的应用
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南京医科大学第一附属医院普外科

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国家自然科学基金项目(81972486)


Application of preoperative ultrasound guided injection of nano-carbon in central lymph nodes dissection of papillary thyroid carcinoma
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Department of General Surgery, The First Affiliated Hospital with Nanjing Medical University

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    摘要:

    目的:本研究从中央区淋巴结数目及染色情况、纳米碳外溢等方面,比较术前超声引导下注射与术中注射纳米碳悬浊液两种不同操作方法的差异,以探寻更优的示踪方法。方法:选取227例甲状腺乳头状癌患者,随机分为术前超声引导注射组106例和术中注射组121例。分析两组患者中央区各亚区淋巴结(颈白线淋巴结、喉前淋巴结、气管前及气管旁淋巴结)数目及染色情况。结果:术中注射组纳米碳外溢比例高于术前超声引导注射组。术前注射组患者颈白线淋巴结数目、气管前及气管旁淋巴结数目均多于术中注射组相应区域淋巴结数目(p值<0.05)。伴桥本氏甲状腺炎患者、术前评估中央区淋巴结异常(cN1)者、肿瘤直径>1cm者,术前超声引导注射纳米碳,中央区淋巴结黒染比例更高(p值<0.05)。结论:术前超声引导注射纳米碳可减少术中染料外溢,提高中央区淋巴结的黒染率和检出率。

    Abstract:

    Objective: to explore a better tracing of central lymph nodes in papillary thyroid cancer patients by comparing the differences of number and staining of central lymph nodes and nano-carbon extravasation between preoperative ultrasound-guided injection and intraoperative injection of nano-carbon. Methods: 227 patients were randomly enrolled into preoperative ultrasound guided injection group and intraoperative injection group. The number and staining of the lymph nodes in each sub-area of central region (linea alba cervical lymph nodes, prelaryngeal lymph nodes, pretracheal and paratracheal lymph nodes) were recorded and analyzed. Results: Central lymph nodes were found to be more and more accessible to be stained by preoperative injection of nano-carbon (p value<0.05). Conclusion: Preoperative ultrasound guided injection of nano-carbon before surgery can reduce dye spillover and improve the staining rate and detection rate of central lymph nodes.

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  • 收稿日期:2022-12-05
  • 最后修改日期:2023-02-03
  • 录用日期:2023-08-09
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