甲状腺癌术后不同剂量首次^131I清除残留甲状腺组织的有效性与安全性评价  

Effectiveness and Safety of First ^131I Ablation of Residual Thyroid Tissue With Different Doses After Surgery of Thyroid Neoplasm

作　　者：庄新所[1] 吴强乐[2] 

机构地区：[1]杭州师范大学附属医院普通外科,浙江省杭州市310015 [2]杭州师范大学附属医院放射科,浙江省杭州市310015

出　　处：《中国全科医学》2015年第29期3555-3557,共3页Chinese General Practice

摘　　要：目的探讨甲状腺癌（TC）术后采用不同剂量131I清除残留甲状腺组织（清甲）的有效性和安全性。方法选取2010年4月—2012年8月在杭州师范大学附属医院接受手术治疗的TC患者76例,按照随机数字表法将其分为低剂量组和高剂量组,每组各38例。低剂量组：空腹一次性口服131I 30~40 m Ci;高剂量组：空腹一次性口服131I100~120 m Ci。清甲6个月后行131I甲状腺显像检查,评价两组清甲成功率;并检测促甲状腺激素（TSH）、甲状旁腺素（PTH）和甲状腺球蛋白（TG）水平;观察两组不良反应发生情况。结果低剂量组清甲成功率为47.4%（18/38）,高剂量组为44.7%（17/38）,两组清甲成功率比较,差异无统计学意义（χ2=0.053,P=0.818）。清甲6个月后,高剂量组TSH、PTH和TG水平均高于低剂量组,差异有统计学意义（t=2.118、6.025、4.412,P〈0.05）。两组唾液腺功能紊乱、颈部疼痛发生率比较,差异均无统计学意义（P〉0.05）;低剂量组胃肠道反应、泪腺功能紊乱发生率均低于高剂量组,差异有统计学意义（P〈0.05）。结论对TC患者术后给予低剂量131I进行清甲治疗,其疗效与高剂量131I无明显差别,安全性优于高剂量131I,值得临床进一步推广。Objective To explore the effectiveness and safety of131 I ablation of residual thyroid tissue with different doses after TC surgery. Methods We enrolled 76 TC patients who underwent surgery in the Affiliated Hospital of Hangzhou Normal University from April 2010 to August 2012. Using random number table,the subjects were divided into low-dose group and high-dose group,with 38 patients in each group. The low-dose group was orally given131 I 30-40 m Ci once in fasting condition,and the high-dose group was orally given131 I 100-120 m Ci once in fasting condition. Six months later,131 I thyroid imaging was examined,and the success rate was evaluated. Levels of TSH,PTH and TG were tested,and the adverse reactions were observed. Results The success rate was 47. 4%（ 18 /38） for low-dose group and 44. 7%（ 17 /38） for high-dose group. The two groups were not significantly different in the success rate（ χ2= 0. 053,P = 0. 818）. Six months after the131 I ablation of residual thyroid tissue,the high-dose group was higher than low-dose group in the levels of TSH,PTH and TG（ t= 2. 118,6. 025,4. 412; P〈0. 05）. The two groups were not significantly different（ P〈0. 05） in the incidence of the salivary dysfunction and cervical pain; the low-dose group was lower（ P〈0. 05） than the high-dose group in the incidence of gastrointestinal reaction and lacrimal gland dysfunction. Conclusion Low-dose131 I ablation of residual thyroid tissue has no much difference in efficacy from that of high-dose, and its safety is superior than high-dose, thus it is worth wider application.

关 键 词：甲状腺肿瘤 碘放射性同位素 促甲状腺素 甲状旁腺素 安全 

分 类 号：R736.1[医药卫生—肿瘤]