不同治疗方法对Ⅳ期分化型甲状腺癌的疗效比较  被引量:5

Comparison of therapeutic effects of different methods on stage IV differentiated thyroid cancer

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作  者:孙东丽[1] 刘炯[1] 申素纲[2] 张宝牛[1] 赵德善[1] Sun Dongli;Liu Jiong;Shen Sugang;Zhang Baoniu;Zhao Deshan(Department of Nuclear Medicine, the Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China;Department of General Surgery, the Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China)

机构地区:[1]山西医科大学第二医院核医学科,太原030001 [2]山西医科大学第二医院普外科,太原030001

出  处:《中国基层医药》2019年第9期1110-1113,共4页Chinese Journal of Primary Medicine and Pharmacy

摘  要:目的比较不同治疗方法对Ⅳ期分化型甲状腺癌(differentiated thyroid cancer,DTC)患者的疗效。方法选择2013年1月至2015年6月山西医科大学第二医院收治的Ⅳ期DTC患者90例按照随机数字表法分为A、B、C三组,每组30例。A组患者采用手术联合碘131(131I)进行治疗,B组患者采用手术联合促甲状腺素(TSH)抑制治疗,C组患者采用手术方案联合131I+TSH抑制方案治疗,评价三组患者治疗效果、术后生活质量评分及近远期生存率。结果治疗后,A组甲状腺球蛋白(Tg)(25.06±3.41)μg/L、C组(24.89±3.27)μg/L水平明显低于B组(45.46±3.58)μg/L;B组(0.36±0.26)mU/L、C组(0.36±0.18)mU/L,患者TSH水平均明显低于A组(0.67±0.31)mU/L(t=3.624、3.337、3.289、3.667,均P<0.05)。A组、C组患者清甲成功率50.00%(15/30)、56.67%(17/30),均明显高于B组患者的33.33%(10/30)(χ^2=3.475、4.967,均P<0.05)。三组患者术后生活质量(GQOLI-74)各维度评分差异有统计学意义(F=4.354、5.216、4.672、5.197,均P<0.05)。C组患者1年(80.00%)、2年(53.33%)、3年(33.33%)生存率明显高于A组(43.33%、36.67%、20.00%)和B组(40.00%、33.33%、16.67%)(χ^2=5.467、3.661、3.287,均P<0.05)。结论对于Ⅳ期分化型甲状腺癌患者,采用手术方案联合131I+TSH抑制方案治疗能够显著提升治疗效果,改善患者术后生存质量,延长生存时间。Objective To investigate the effect of different treatment methods on the survival of patients with stage IV differentiated thyroid cancer (DTC). Methods From January 2013 to June 2015, 90 patients with stage IV DTC in the Second Hospital of Shanxi Medical University were randomly divided into three groups according to the digital table, A, B and C group, with 30 cases in each group.The patients in A group were treated with surgery combined with 131I, and the patients in B group were treated with surgery combined with TSH inhibition, and the patients in C group were treated with operation combined with 131I + TSH inhibition.The therapeutic effect, postoperative quality of life score and short-term and long-term survival rate were evaluated. Results After treatment, the levels of Tg in A group [(25.06±3.41)μg/L] and C group [(24.89±3.27)μg/L] were significantly lower than that in B group [(45.46±3.58)μg/L], and the levels of TSH in B group [(0.36±0.26)mU/L] and C group [(0.36±0.18)mU/L] were significantly lower than that in A group [(0.67±0.31)mU/L](t=3.624, 3.337, 3.289, 3.667, all P<0.05). The success rates of nail clearance in A group and C group were 50.00%(15/30) and 56.67%(17/30), respectively, which were significantly higher than 33.33%(10/30) in B group (χ^2=3.475, 4.967, all P<0.05). The postoperative quality of life (GQOLI-74) scores among the three groups had statistically significant differences (F=4.354, 5.216, 4.672, 5.197, all P<0.05). The 1-year (80.00%), 2-year (53.33%) and 3-year (33.33%) survival rates in C group were significantly higher than those in A group (43.33%, 36.67%, 20.00%) and B group (40.00%, 33.33%, 16.67%)(χ^2=5.467, 3.661, 3.287, all P<0.05). Conclusion For patients with stage IV DTC, the combination of 131I+ TSH inhibitory regimen and operation regimen can significantly improve the therapeutic effect, improve the quality of life and prolong the survival time.

关 键 词:甲状腺肿瘤 促甲状腺素 甲状腺球蛋白 碘放射性同位素 

分 类 号:R736.1[医药卫生—肿瘤]

 

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