老年分化型甲状腺癌患者应用外科手术切除联合^(131)I治疗的临床疗效及并发症情况  

Clinical efficacy and complications of surgical resection combined with 131I therapy in elderly patients with differentiated thyroid cancer

作　　者：张扬[1] 刘娜[1] 张秋菊 韩笑 王雪冰 万紫旭[1] Zhang Yang;Liu Na;Zhang Qiuju;Han Xiao;Wang Xuebing;Wan Zixu(Department of Surgery,Chengde Vocational College of Nursing,Chengde 067000,China;Chengde Central Hospital,Chengde 067000,China)

机构地区：[1]河北承德护理职业学院外科教研室,承德067000 [2]河北承德市中心医院,承德067000

出　　处：《中华地方病学杂志》2022年第11期914-917,共4页Chinese Journal of Endemiology

摘　　要：目的探讨老年分化型甲状腺癌患者应用外科手术切除联合碘-131(^(131)I)治疗的临床疗效及对并发症等的影响。方法选择河北承德市中心医院于2019年3月至2021年3月收治的老年分化型甲状腺癌患者82例, 依据随机数字表法分为观察组(41例)与对照组(41例)。对照组行甲状腺全切术+颈部淋巴结清扫术, 观察组在对照组基础上给予^(131)I治疗。对两组患者各项指标进行评价(术后观察时间节点为3个月), 包括围手术期指标, 术后并发症情况, 治疗前后卡氏功能状态(KPS)评分、血清淋巴细胞活化基因-3(LAG-3)和重组人Dick-kopfx相关蛋白-1(DKK-1)的变化, 以及疗效情况。结果两组患者术中出血量和手术时间比较差异均无统计学意义(P均> 0.05);观察组住院时间[(6.72 ± 1.39)d]短于对照组[(8.78 ± 1.43)d, P < 0.001]。观察组并发症发生率(31.71%, 13/41)低于对照组(53.66%, 22/41, P = 0.045)。两组患者治疗后KPS评分均高于治疗前(P均< 0.001);治疗后观察组KPS评分高于对照组(P < 0.001)。两组患者治疗后血清LAG-3水平均高于治疗前, 而DKK-1水平均低于治疗前(P均< 0.001);治疗后观察组血清LAG-3水平高于对照组, 而DKK-1水平低于对照组(P均< 0.001)。观察组总有效率(95.12%, 39/41)高于对照组(80.49%, 33/41, P = 0.043)。结论老年分化型甲状腺癌患者应用外科手术切除联合^(131)I治疗临床疗效良好, 且可降低术后并发症, 以及上调LAG-3表达、下调DKK-1表达。Objective To study the clinical efficacy of surgical resection combined with iodine-131(131I)therapy in elderly patients with differentiated thyroid cancer and its influence on complications.Methods Totally 82 elderly patients with differentiated thyroid cancer who were admitted to Chengde Central Hospital from March 2019 to March 2021 were selected and divided into observation group(41 cases)and control group(41 cases)according to the random number table.The control group underwent total thyroidectomy+neck lymph node dissection,and the observation group was treated with 131I after the operation on the basis of the control group.The indicators in the two groups were evaluated(postoperative observation time cutoff was 3 months),including perioperative indexes,postoperative complications,Karnofsky(KPS)score,serum levels of lymphocyte activating gene-3(LAG-3)and recombinant human Dick-kopfx related protein-1(DKK-1)before and after treatment,and the efficacy.Results There was no significant difference between the two groups in the amount of intraoperative bleeding and operation time(P>0.05);the hospitalization time in the observation group[(6.72±1.39)d]was shorter than that in the control group[(8.78±1.43)d,P<0.001].The incidence of complications in the observation group(31.71%,13/41)was lower than that in the control group(53.66%,22/41,P=0.045).After treatment,KPS scores in the two groups were higher than those before treatment(P<0.001);after treatment,KPS score in the observation group was higher than that in the control group(P<0.001).After treatment,the serum LAG-3 levels in the two groups were higher than those before treatment,while DKK-1 levels were lower than those before treatment(P<0.001);after treatment,the serum LAG-3 level in the observation group was higher than that in the control group,while the DKK-1 level was lower than that in the control group(P<0.001).The total effective rate of the observation group(95.12%,39/41)was higher than that of the control group(80.49%,33/41,P=0.043).Conclusion The cli

关 键 词：外科手术 分化型甲状腺癌 碘-131 临床疗效 并发症 

分 类 号：R736.1[医药卫生—肿瘤]