文献类型：期刊文献

中文题名：纳米碳示踪剂在达芬奇机器人甲状腺癌根治术中的应用

英文题名：Application of Nano-carbon Tracer in Da Vinci Robot-assisted Radical Thyroidectomy

作者：韩博强[1,2];马有伟[3];于建平[3];刘宏斌[3];韩晓鹏[3]

第一作者：韩博强

机构：[1]甘肃中医药大学临床医学院,兰州730000;[2]咸阳市中心医院肝胆外科,咸阳712000;[3]解放军联勤保障部队第940医院普外科,兰州730050

第一机构：甘肃中医药大学临床医学院

年份：2020

卷号：47

期号：4

起止页码：288

中文期刊名：肿瘤防治研究

外文期刊名：Cancer Research on Prevention and Treatment

收录：CSTPCD;;CSCD:【CSCD_E2019_2020】；

基金：甘肃省自然科学基金(1506RJZA309);陕西省科技厅项目(2017SF-232)。

语种：中文

中文关键词：纳米碳;甲状腺癌;达芬奇机器人;淋巴结;甲状旁腺;喉返神经

外文关键词：Nano-carbon;Thyroid carcinoma;Da Vinci robot;Lymph nodes;Parathyroid glands;Laryngeal recurrent nerve

摘要：目的探讨在达芬奇机器人甲状腺癌根治术中应用纳米碳示踪剂对淋巴结清扫及甲状旁腺、喉返神经保护的作用。方法收集实施达芬奇机器人甲状腺乳头状癌根治术的60例患者资料,按照随机对照的方法分为研究组(30例)和对照组(30例),对照组行常规达芬奇甲状腺癌根治术,研究组术中加用纳米碳示踪剂。对两者术后Ⅵ区淋巴结清扫总数及阳性数目、血钙、PTH水平、低钙血症发生率、甲状旁腺功能减退发生率、甲状旁腺误切率、喉返神经损伤发生率进行比较。结果研究组和对照组Ⅵ区总淋巴结检出数分别为247和173枚(Z=-2.228,P=0.026),阳性淋巴结检出数分别为99和65枚(Z=-1.986,P=0.047);两组术后第1、2天血钙及PTH水平均较术前1天下降,但研究组术后第1、2天血钙及PTH水平较对照组高,差异有统计学意义(P<0.05);两组术后暂时性甲状旁腺功能减退分别为4例(13.3%)和11例(36.7%),差异有统计学意义(P<0.05)。结论在达芬奇机器人甲状腺癌根治术中应用纳米碳示踪剂可以更好清扫Ⅵ区淋巴结,同时能有效保护甲状旁腺,但对喉返神经无肯定保护作用。
Objective To evaluate the effect of nano-carbon tracer on lymph node dissection and protection of parathyroid gland and recurrent laryngeal nerve in Da Vinci robot-assisted radical thyroidectomy.Methods Sixty patients who underwent Da Vinci robot-assisted radical thyroidectomy were randomly divided into research group(n=30)and control group(n=30).The control group received conventional Da Vinci robotassisted radical thyroidectomy,while the research group added nano-carbon tracer during operation.The total and positive number of lymph node dissection in areaⅥ,the level of serum calcium and PTH,and the incidence of hypocalcemia,hypoparathyroidism,mistaken dissection of parathyroid gland and recurrent laryngeal nerve injury were compared between the two groups after surgery.Results The total lymph nodes in area VI of research and control groups were 247 and 173(Z=-2.228,P=0.026),the positive lymph nodes were 99 and 65(Z=-1.986,P=0.047),respectively;the levels of serum calcium and PTH decreased on the first day and second day after surgery,compared with the last day before surgery in both groups,but the levels of serum calcium and PTH in the research group were higher than those in the control group on the first day and second day after surgery(P<0.05).There were 4(13.3%)and 11(36.7%)cases of temporary hypoparathyroidism after surgery in the research group and the control group(P<0.05).Conclusion The application of nano-carbon tracer in Da Vinci robot-assisted radical thyroidectomy could better improve the dissection of lymph node in areaⅥand effectively protect parathyroid glands,but it has no definite protective effect on recurrent laryngeal nerve.