Clinical Research Of Carbon Nanoparticles On Parathyroid Protection In Operation Of Thyroid Carcinoma

Objective:1.To investigate the value of carbon lymphatic tracer on parathyroid protection in thyroid cancer surgery;2.To study the clinic value of carbon nanoparticles on central lymphadenectomy.Method:This study was a randomized controlled prospective study.From2015 March to 2015 December,we selected the 400 inclusion criteria patients with suspected thyroid carcinoma in thyroid surgery of Shanghai No.6 People's Hospital.These cases were randomly divided into carbon nanoparticles group(experimental group)and conventional surgery group(control group).Each group has 200 cases.The former underwent nano carbon intrathyroidal injection in the surgery.It made thyroid and lymph nodes near the tumor more clear.At the same time,the latter through regular operation.After that we observed two groups in age,gender,tumor size,operative time,hospitalization time,intraoperative blood loss;determined and compared the two groups in level of serum calcium and PTH before and after operation 1?3?7 day and 1 mouth;statistics and compared between the two groups in the number of lymph node dissection;record and compared the two groups of parathyroid mistaken cut.Measurement data was used mean±standard deviation to express,and the groups set of data were compared using a t-test.Count data groups were compared with corrected X~2 test by using SPSS20.0 statistical analysis software,P<0.05 was considered statistically significant.Result:1.Carbon nanoparticles group and conventional surgery group had no statistical difference in the sex,age,tumor size,serum calcium and PTH levels before operation(P>0.05),so the two groups had comparability.2.There was no significant statistical difference in the amount of blood loss,postoperative hospital stay and operation time between the carbon nanoparticles group and the conventional surgery group(P>0.05).3.Nano carbon groups occurred in 6 cases of mistaken parathyroidectomy(mistakenly cut rate 3.00%);While,there were 35accidentally cut cases in the conventional surgery group(mistakenly cut rate 17.50%),the carbon nanoparticles group accidentally remove rate was significantly lower than that in the control group,with has statistically significance(P<0.05).4.The number of lymph node resected in carbon nanoparticles group and routine operation group were 1535 and 816,and the rate of lymph node metastasis in carbon nanoparticles group and routine operation group were 41.50%and 11.5%.There had statistically significant difference between carbon nanoparticles group patients and routine operation group in central lymph node dissection number and lymph node metastasis rate(P<0.05).5.The rate of postoperative hypocalcemia symptoms in carbon nanoparticles group and routine operation group were 9.00%(18 cases had hypocalcemia symptoms)and 21.50%(43 cases appear afore-mentioned symptoms).23(11.50%)cases had a transient lowering of serum calcium in carbon nanoparticles group,while,the conventional surgery group had 51(25.50%)similar cases.The average level of serum calcium after operation 1?3?7 day and 1 mouth in carbon nanoparticles group is higher than that in conventional surgery group.The carbon nanoparticles group patients had lower rate than conventional surgery group patients in hypocalcemia symptoms and a short time decreasing of calcium.These had statistically differences(P<0.05).6.The rate of temporary reduction in PTH was 9.00%(occurred in18 cases)in carbon nanoparticles group and was 24.50%in conventional surgery group(49 cases occurred temporary reduction in PTH).The average level of PTH after operation 1?3?7 day and 1 mouth in carbon nanoparticles group is higher than that in conventional surgery group.Two groups had statistical differences(P<0.05).Conclusion:1.With the help of nano carbon suspension,the thyroid and lymph node can be appeared more conveniently and rapidly,at the same time the parathyroid does not appear.This can help doctors to recognize parathyroid and reduce the damage of parathyroid.2.In the operation of thyroid cancer,nano carbon suspension injection can significantly reduce the incidence of low calcium and low serum PTH,that is to say,it can effectively reduce the incidence of postoperative parathyroid function reduction.3.With the application of nano carbon suspension,the rate of central lymph node dissection in thyroid cancer surgery can be incread.4.The operation time,intraoperative bleeding volume,postoperative hospitalization days will not increase by the use of nano carbon suspension.