碘131联合左甲状腺素片治疗老年中高危分化型甲状腺癌术后患者临床疗效研究  

CLINICAL EFFICACY OF IODINE-131 COMBINED WITH LECOTHYROXINE TABLETS IN ELDERLY PATIENTS WITH INTERMEDIATE AND HIGH-RISK DIFFERENTIATED THYROID CANCER AFTER SURGERY

作　　者：白杨[1] 靳健 刘永红[1] 张步勇 张博[1] 李杰[1] BAI Yang;JIN Jian;LIU Yonghong;ZHANG Buyong;ZHANG Bo;LI Jie(Cangzhou City Cen tral Hospital,CangZhou 061000,China)

机构地区：[1]河北省沧州市中心医院甲状腺乳腺外四科,061000

出　　处：《中国煤炭工业医学杂志》2023年第2期119-124,共6页Chinese Journal of Coal Industry Medicine

基　　金：2019年河北省卫生健康委医学科学研究课题计划(编号:20191269)。

摘　　要：目的 探讨碘131联合左甲状腺素片对老年中高危分化型甲状腺癌根治术后患者临床疗效。方法 选择2016年6月—2018年6月该院甲状腺乳腺外科收治的78例老年中高危分化型甲状腺癌患者作为观察对象进行回顾性研究,以治疗方法不同分为对照组40例和观察组38例。二组患者均进行了甲状腺癌根治手术,对照组术后给予左甲状腺素片治疗,观察组在给予左甲状腺素片治疗基础上联合应用碘131治疗;观察二组患者治疗前后血清甲状腺球蛋白(Tg)水平及甲状腺球蛋白抗体(TgAb)水平变化,临床治疗效果,不良反应发生率情况以及随访3年患者复发率、转移率情况。结果 二组甲状腺癌根治术后患者治疗前血清甲状腺球蛋白及甲状腺球蛋白抗体水平比较差异均无统计学意义(均P>0.05),治疗后二组血清甲状腺球蛋白及甲状腺球蛋白抗体水平均低于治疗前,且碘131联合左甲状腺素片治疗的观察组血清甲状腺球蛋白及甲状腺球蛋白抗体水平明显低于对照组,差异有统计学意义(P<0.05);观察组治疗效果(总有效率)明显高于对照组,差异有统计学意义(P<0.05);观察组出现术后不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。二组患者3年复发率、转移率随访,观察组复发率、转移率均低于对照组,差异有统计学意义(P<0.05)。结论 碘131联合左甲状腺素片应用于老年中高危分化型甲状腺癌根治术患者,降低患者血清中血清甲状腺球蛋白及甲状腺球蛋白抗体水平,可有效提高治疗效率,降低术后肿瘤复发和转移风险,延长患者生存期,且安全性高。Objective To investigate the clinical efficacy of iodine-131 combined with levothyroxine tablets in elderly patients with moderate and high-risk differentiated thyroid carcinoma after radical resection. Methods Seventy-eight elderly patients with middle and high-risk differentiated thyroid cancer admitted to the head and Neck Surgery Department of Tangshan People's Hospital from June 2016 to June 2018 were selected for a retrospective study, which were divided into forty patients in the control group and thirty-eight patients in the observation group with different treatment methods.All two groups of patients underwent radical surgery for thyroid cancer.The patients in the control group were treated with levothyroxine tablets after operation, and the patients in the observation group were treated with iodine 131 on the basis of levothyroxine tablets.The changes of serum thyroglobulin(Tg) level and thyroglobulin antibody(TgAb) level before and after treatment, clinical treatment effect, incidence of adverse reactions, recurrence rate and metastasis rate after 3 years of follow-up were observed in the two groups. Results There was no significant difference in the serum levels of thyroglobulin and thyroglobulin antibody between the two groups before treatment(P>0.05),and the serum levels of thyroglobulin and thyroglobulin antibody in the two groups after treatment were lower than before treatment.The levels of serum thyroglobulin and thyroglobulin antibody in the observation group treated with iodine-131 combined with levothyroxine tablets were significantly lower than those in the control group, and the differences were statistically significant(P<0.05).The treatment effect(total effective rate) of the observation group was significantly higher than that of the control group, and the difference was statistically significant(P<0.05).The incidence of postoperative adverse reactions in the observation group was significantly lower than that in the control group, and the difference was statistically significant(P<0.05)

关 键 词：碘131 左甲状腺素钠片 甲状腺癌 

分 类 号：R73[医药卫生—肿瘤]