| Objective:To investigate the feasibility and clinical value of methylene blue locali zation of sentinel lymph node in the surgical treatment of papillary thyroid carcinomaMethods:In this study,we retrospectively analyzed the clinical data of 60 patients with thyroid cancer admitted to our hospital during January 2015 to December 2015 and were divided into control group according to whether or not injection of met hylene blue injection was performed.There were 28 patients without the methylene blue positioning group and 32 patients with the localization group(methylene blue positioning group).The age,operation time,body mass index,intraoperative blood loss,postoperative drainage,and hospital stay were compared between the two gro ups.The number of lymph node dissections was counted,and the number of lymph node metastases in lymph nodes stained with methylene blue was counted;the met astasis rates of sentinel lymph nodes and actual lymph nodes were compared;patie nts were evaluated for hoarseness,drinking water,tetany,facial tingling,etc.Postop erative complications.Statistical methods SPSS20.0 software was used for statistical analysis.Results:A total of 182 central lymph nodes were removed from the control group,and 288 central lymph nodes were removed from the localization group.Among th em,the number of detections in the methylene blue positioning group was(9.0±1.93)pieces/case,the number of detections in the control group was(6.5±2.40)pieces/case,and the detection number of lymph nodes in the positioning group was signifi cantly more than that in the control group(P<0.01).),there was a statistical differe nce between the two groups.The lymph node metastasis rate was 15.6% in the met hylene blue positioning group and 17.9% in the control group.There was no signifi cant difference between the two groups(x2=0.745;p=0.388>0.05).Blue metastatic l ymph node metastasis in the methylene blue localization group The rate was 17.9%,and the rate of lymph node metastasis was not 5%.The difference was statistically significant(p=0.024<0.05).Five of the 32 patients in the methylene blue localizati on group had SLN metastases;2 had non-SLN metastases;12 patients had both SL N and non-SLN metastases;and 13 patients had no lymph node metastases.The SL N detection rate was 100%,the accuracy was 93.75%,the sensitivity was 89.47%,t he specificity was 100%,the false negative rate was 8%,and the false positive rate was 0%.There was no significant difference in age,gender,BMI,operation time,intraoperative blood loss,and postoperative drainage between the two groups(p>0.05).There was no statistically significant difference in the incidence of hoarse voice,drinking water,cough,and hematoma after operation(P>0.05).The incidence of m ethylene blue-induced postoperative complications was significantly lower in the me thylene blue group than in the control group(p<0.05).Conclusion:Methylene blue can effectively locate the sentinel lymph node in the s urgical treatment of papillary thyroid carcinoma,can accurately reflect the status of lymph nodes in the neck,increase the detection rate of SLN,and have guiding sig nificance for the choice of surgical methods and PTC lymph node dissection during surgery.It is worth promoting..And the use of methylene blue dye trace during t he operation did not prolong the operation time,increased postoperative drainage dr ainage and postoperative complications.At the same time,it helps the surgeon to i dentify and protect the parathyroid gland and its blood supply during surgery.It is a comparatively practical clinical technique. |
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