分化型甲状腺癌术后促甲状腺激素抑制治疗现状和思考  

Current status and thinking of postoperative thyroid stimulating hormone suppression therapy for differentiated thyroid cancer

作　　者：程若川[1] CHENG Ruo-chuan(Department of Thyroid Surgery,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院甲状腺疾病诊治中心,云南昆明650032

出　　处：《中国实用外科杂志》2023年第4期391-396,共6页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.821604622);云南省“万人计划”—名医专项(No.RLCRC20210412)。

摘　　要：治疗达标率低是目前促甲状腺激素(TSH)抑制治疗面临的主要问题。循证医学证据显示,TSH抑制治疗可降低分化型甲状腺癌病人肿瘤复发风险,延长生存时间。回顾指南演变过程,从初始复发风险分层概念的提出和细化、复发风险低危者TSH控制目标放宽,到动态疗效与副反应双风险评估体系的建立,可以看出TSH抑制治疗与监测正在从是否达标并积极防治副反应,向个体化、精准化、动态评估的方向发展。如何加强对病人进行规律、有效的随访,迫切需要主诊医师积极主动参与现代智能化随访模式的研发与实施。The low rate of reaching the treatment target is the main problem faced by thyroid stimulating hormone(TSH)inhibition therapy at present.Evidence-based medical evidence shows that TSH inhibition therapy can reduce the risk of tumor recurrence and prolong survival time in patients with differentiated thyroid cancer.Reviewing the evolution of the guidelines,from the introduction and refinement of the concept of initial recurrence risk stratification,the relaxation of TSH control objectives for those at low risk of recurrence,to the establishment of a dual risk assessment system for dynamic efficacy and side effects,it can be seen that TSH inhibition treatment and monitoring are moving towards personalized,accurate,and dynamic evaluation,from meeting standards and actively preventing and treating side effects.How strengthen regular and effective follow-up for patients urgently requires the attending physician to actively participate in the development and implementation of a modern intelligent follow-up model.

关 键 词：分化型甲状腺癌 术后管理 促甲状腺激素 促甲状腺激素抑制治疗 

分 类 号：R6[医药卫生—外科学]