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目的评价纳米炭在胃癌根治术中的淋巴示踪效果。方法 86例胃癌患者随机分为试验组(n=43)和对照组(n=43),试验组患者术中于肿瘤边缘浆膜下注射纳米炭进行胃周淋巴结示踪,对照组患者直接手术,对2组患者淋巴结清扫结果、手术时间及术后并发症进行比较。结果试验组患者每例清扫淋巴结(30.20±11.63)枚(17~45枚),明显高于对照组的(22.47±7.60)枚(15~31枚),P<0.05。试验组患者淋巴结的黑染率为74.56%(1 260/1 690),在有转移的302枚淋巴结中,黑染的数目为185枚,黑染率为61.26%;非黑染的数目为117枚,占38.74%,两者差异有统计学意义(P<0.05)。试验组患者手术时间〔(3.51±0.43)h〕与对照组〔(3.49±0.51)h〕的差异无统计学意义(P>0.05)。2组患者术后并发症发生情况无差异,未见纳米炭引起的局部及全身不良反应。结论胃癌根治术应用纳米炭进行淋巴结示踪是安全的,对淋巴结清扫及检出有一定的指导作用。
Objective To evaluate the effect of nanometer charcoal on lymph node tracing in radical resection of gastric cancer. Methods Eighty-six patients with gastric cancer were randomly divided into experimental group (n = 43) and control group (n = 43). The patients in the experimental group were injected subcutaneously with charcoal on the margins of the tumor for gastric lymph node tracing, while the control group received direct surgery The results of lymph node dissection, operation time and postoperative complications in two groups were compared. Results The number of lymph nodes (30.20 ± 11.63) (17-45) in each experimental group was significantly higher than that of the control group (22.47 ± 7.60) (15-31) (P <0.05). In the experimental group, the rate of black staining was 74.56% (1 260/1 690) in the lymph nodes of the patients in the experimental group. The number of black dye was 185 in the 302 lymph nodes with metastasis, the black dye rate was 61.26%; the number of non-black dye was 117 Pieces, accounting for 38.74%, the difference was statistically significant (P <0.05). There was no significant difference in the operation time (3.51 ± 0.43 h) between the experimental group and the control group (3.49 ± 0.51 h) (P> 0.05). There was no difference in postoperative complications between the two groups. No local or systemic side effects caused by nano-carbon were observed. Conclusion It is safe to use nanocarbon for lymph node tracing in radical operation of gastric cancer, which can guide lymph node dissection and detection.