Using Thyroid Lymphography To Protect Parathyroid And Detect Senile Lymph Node

Objective: To introduce the methods and clinical efficacy of Thyroid Lymphography(TLG) using carbon nanoparticle or methylene blue,and its Injection points, tracer characteristics, Compare the advantages and disadvantages of two tracer; the role of thyroid lymphography in protecting parathyroid glands and detecting lymph node metastasis.Methods:A total of121patients with clinically node-negative papillary thyroid carcinoma were meet selected criteria and enrolled,and81of them underwent thyroid lymphography.48of them inject0.2ml carbon nanoparticle,33of them inject0.2ml methylene blue around the tumors, observe the morphology of thyroid and parathyroid,and the black-stained lymph nodes were collected from the central compartments. Statistics two groups each seizure of number of lymph nodes, and lymph node specimens were divided into dyed and undyed for pathological examination, which to understand each group lymph node metastasis. We also selected40cases the CNO of papillary thyroid cancer as conventional surgery group, using conventional surgical procedures revealed parathyroid and for lymph node dissection, controlled observat the parathyroid protection and seized lymph nodes.Results:the injection of carbon nanoparticle and methylene blue led to no major complications such as anaphylaxis, the lymph nodes were stained black by carbon nanoparticle, stained blue by methylene blue, and parathyroid gland was not dyed, all this remind the surgeons of protecting the parathyroid glands. The pathologic examination revealed no parathyroid was mistakenly cut. There was no case of patients with permanent hypoparathyroidism. AS for carbon nanoparticle group, the average initial tracer time was8.2±3.8seconds, compared to11.2±4.7seconds with the methylene blue group,the difference was statistically significant. The average duration of tracer time of the methylene blue group is23±5minutes, while the carbon nanoparticle group until the end of surgery, there are still some tracer stay. Group of thyroid lymphatic tracer the parathyroid mistakenly cut rate is lower than the conventional surgery group. The test group and the conventional surgery group were seized received lymph node567, the carbon nanoparticle group, methylene blue group and conventional surgery group were(7.6±4.1) pieces/cases;(5.1±4.4) pieces/cases;(3.7±4.9) pieces/cases; Stained lymph node metastasis was higher than unstained lymph node.Conclusions:1)The technipue of thyroid Lymphography has feasibility and safety in clinical applications;2)using carbon nanoparticle and methylene blue may remind the surgeons of protecting the parathyroid glands,3)TLG can improve the the seizure rate of lymph node at postoperative pathological examination;4) the average initial tracer time of carbon nanoparticle is shorter than methylene blue, the average continuous tracer time is longer, and the lymphatic tropism is stronger than methylene blue;5) Stained lymph node do not means metastasis, the method of TLG can only use as indicate lymphatic drainage, and cannot indicated the metastases of lymph node.