131^I联合外科手术治疗分化型甲状腺癌疗效观察  

Observation on the efficacy of 131 iodine combined with surgical treatment for differentiated thyroid cancer

作　　者：原武红 陈艳峰 师静梅 

机构地区：[1]运城同德医院内分泌甲状腺科,山西省运城044000

出　　处：《中国基层医药》2015年第19期2986-2989,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨分化型甲状腺癌（DTC）术后淋巴结转移临床使用131 I 治疗的方式与效果。方法采用随机抽样法选取术后淋巴结转移的 DTC 患者185例，均予以规范131 I 治疗，评价131 I 治疗的 B 超、CT、Tg变化、131 I 显像特点，判定临床疗效。结果影像学变化：全组患者中，治疗有效153例（82．7％）。153例治疗有效的患者，105例经检查 LMDTC 完全消除（56．8％），48例检查发现缩小（25．9％）。单纯淋巴结转移者治疗后影像学检查结果优于合并脏器转移的患者（χ^2＝2．57，P ＝0．02）；淋巴结较小的患者治疗后影像学检查结果优于淋巴结直径相对大的患者（P ＞0．05）。Tg 水平变化：185例患者 Tg 显著下降97例（51．1％），54例患者一般下降（29．2％）；单纯淋巴转移者治疗后 Tg 改善效果优于合并其他脏器转移患者（χ^2＝3．41，P ＝0．01）；淋巴结直径较小患者治疗后 Tg 改善效果优于合并其他脏器转移患者（χ^2＝6．34，P ＝0．02）。结论131 I 治疗 DTC 患者术后淋巴结转移综合疗效显著，值得在 DTC 临床中运用推广。Objective To discuss differentiated thyroid carcinoma （DTC）postoperative lymph node metas-tasis and clinical use and the effect of 131 I treatment.Methods to185 patients with lymph node metastasis of DTC were selected by random sampling method.The standard 131 I treatment was administrated,ultrasound,CT and Tg chan-ges and imaging characteristics of 131 I treatment were evaluated the clinical curative effect was determined.Results Imaging changes：the whole group of patients,153 patients （82.7%）were effective.153 patients with effective treat-ment,105 cases examined LMDTC completely eliminate （56.8%）,48 cases examination revealed narrowing （25.9%）.Mere lymph node metastasis after treatment was better than that of patients with viscera metastasis,imaging examination results were statistically significant differences （χ2 =2.57,P =0.02）.After treatment,imaging examina-tion result in patients with smaller lymph node was superior to that in the patients with relatively large diameter lymph nodes （P 〉0.05）.Tg level changes：there was a significant reduction in the Tg 97 cases of 185 patients （51.1%）, and general decline in 54 patients （29.2%）.Tg improvement effect of patients with mere lymphatic metastasis after treatment was better than other viscera metastasis in patients with statistically significant differences （χ2 =3.41,P =0.01）.Lymph node Tg improved after treatment in patients with small diameter,which was better than that with other viscera metastasis patients with statistically significant differences（χ2 =6.34,P =0.02）.Conclusion Comprehensive curative effect of 131 I treatment of lymph node metastasis postoperatively in patients with DTC is distinct,and is worth popularizing in clinical use of DTC.

关 键 词：甲状腺肿瘤 碘同位素 

分 类 号：R736.1[医药卫生—肿瘤]