^131Ⅰ联合手术治疗老年分化型甲状腺癌的效果及预后  

Effect and prognosis of ^131Ⅰcombined operation in the treatment of differentiated thyroid cancer in the elderly

作　　者：林枫 余敏 罗文溢 张波 史育红[1] LIN Feng;YU Min;LUO Wenyi;ZHANG Bo;SHI Yuhong(Department of Nuclear Medicine,the 2nd Affiliated Hospital of Chengdu Medical CollegeNuclear Industry 416 Hospital,Sichuan Province,Chengdu610051,China)

机构地区：[1]成都医学院附属第二医院核工业四一六医院核医学科,四川成都610051

出　　处：《中国医药导报》2021年第2期102-105,共4页China Medical Herald

摘　　要：目的研究131碘(^131Ⅰ)联合手术治疗老年分化型甲状腺癌的效果及预后。方法选择成都医学院附属第二医院2016年1月-2017年10月收治的82例老年分化型甲状腺癌患者进行研究。患者均接受甲状腺全切或甲状腺近全切术,并进行颈部淋巴结清扫,再给予^131Ⅰ治疗。观察患者治疗效果,手术前后甲状腺球蛋白、甲状腺球蛋白抗体变化情况、不良反应、复发和生存情况。结果82例老年分化型甲状腺癌患者经1次^131Ⅰ治疗清甲成功者为53例,2次^131Ⅰ治疗后清甲成功者为19例,总清甲成功率为87.80%。术后6个月,患者的甲状腺球蛋白水平、抗甲状腺球蛋白抗体阳性率均较治疗前降低,差异均有统计学意义(均P<0.05)。131I治疗期间,少数患者发生咽部不适、颈部肿胀、腹部不适等短期不良反应,未见严重肺纤维化、骨髓抑制、肝肾功能损伤。随访结束时复发4例,死亡3例。结论^131Ⅰ联合甲状腺全切或甲状腺近全切术治疗老年分化型甲状腺癌安全、有效、预后良好,值得临床推广应用。Objective To study the effect and prognosis of 131Iodine(^131Ⅰ)combined operation for elderly differentiated thyroid cancer.Methods A total of 82 elderly patients with differentiated thyroid cancer treated in the 2nd Affiliated Hospital of Chengdu Medical College from January 2016 to October 2017 were selected for this study.All patients received total thyroidectomy or near total thyroidectomy,and neck lymph node dissection,and then treated with^131Ⅰ.The therapeutic effect,changes of thyroglobulin and thyroglobulin antibody before and after operation,adverse reactions,recurrence and survival situation were observed.Results Among 82 elderly patients with differentiated thyroid cancer,53 cases were successfully treated after the first^131Ⅰtreatment,and 19 cases were successfully treated after the second^131Ⅰtreatment,with a total success rate of 87.80%.Six months after operation,the level of thyroglobulin and the positive rate of anti-thyroglobulin antibody were significantly lower than those before treatment,the differences were statistically significant(all P<0.05).During^131Ⅰtreatment,a few patients had short-term adverse reactions such as throat discomfort,neck swelling,abdominal discomfort,and no serious pulmonary fibrosis,bone marrow suppression,liver and kidney function damage.At the end of follow-up,four cases relapsed and three cases died.Conclusion^131Ⅰcombined with total thyroidectomy or near total thyroidectomy is safe,effective and has a good prognosis in the treatment of differentiated thyroid cancer in the elderly,which is worthy of clinical application.

关 键 词：分化型甲状腺癌 老年 131碘 手术 效果 预后 

分 类 号：R736.1[医药卫生—肿瘤]