甲状腺全切除术治疗分化型甲状腺癌患者的临床效果及对甲状腺激素、并发症的影响  

Clinical Outcome of Total Thyroidectomy for Patients with Differentiated Thyroid Cancer and Its Effect on Thyroid Hormones and Complications

作　　者：张昌稳 ZHANG Changwen(Department of General Surgery,the Third Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu Province,221000 China)

机构地区：[1]徐州医科大学附属第三医院普外科,江苏徐州221000

出　　处：《中外医疗》2023年第33期18-21,30,共5页China & Foreign Medical Treatment

摘　　要：目的 探究甲状腺全切除术治疗分化型甲状腺癌患者的临床效果及对甲状腺激素、并发症的影响。方法 回顾性分析2022年1月—2023年4月在徐州医科大学附属第三医院收治的75例分化型甲状腺癌患者的临床资料,根据不同手术方式分为对照组和研究组,将37例行甲状腺近全切术治疗的患者归入对照组,将38例行甲状腺全切术治疗的患者归入观察组。比较两组围术期指标、甲状腺激素水平、并发症、短期复发、短期转移情况。结果 观察组围术期各项指标均优于对照组,差异有统计学意义(P<0.05);观察组术后游离甲状腺素(free thyroxin, FT4)、游离三碘甲状腺原氨酸(free triiodothyronine, FT3)高于对照组,促甲状腺激素(thyroid stimulating hormone, TSH)低于对照组,差异有统计学意义(t=5.559、2.991、13.386,P<0.05);两组并发症发生率、短期转移率比较,差异无统计学意义(P>0.05);观察组短期复发率2.63%低于对照组的21.62%,差异有统计学意义(χ^(2)=4.730,P<0.05)。结论 对分化型甲状腺癌患者实施甲状腺全切术治疗,围术期效果理想,可改善患者机体甲状腺激素水平,降低患者短期病情复发的风险。Objective To investigate the clinical effect of total thyroidectomy in treating patients with differentiated thyroid cancer and its effect on thyroid hormones and complications.Methods The clinical data of 75 patients with differentiated thyroid cancer admitted to the Third Affiliated Hospital of Xuzhou Medical University from January 2022 to April 2023 were analyzed retrospectively.According to different surgical methods,they were divied into control group and observation group 37 patients treated with subtotal thyroidectomy were categorized into the control group and 38 patients treated with total thyroidectomy were categorized into the observation group.The perioperative indicators,thyroid hormone levels,complications,short-term recurrence and short-term metastasis were compared between the two groups.Results The perioperative indexes of the observation group were better than those of the control group,and the difference were statistically significant(P<0.05).Free thyroxin(FT4)and free triiodothyronine(FT3)were higher than those of the control group,and the difference were statistically significant(P<0.05).Thyroid stimulating hormone(TSH)was lower than that of the control group in the observation group after surgery,and the difference were statistically significant(t=5.559,2.991,13.386,P<0.05).There was no significant difference in complication rate and short-term metastasis rate between the two groups(P>0.05).The short-term recurrence rate of 2.63%in the observation group was lower than that of 21.62%in the control group,and the difference were statistically significant(χ^(2)=4.730,P<0.05).Conclusion The perioperative effect of total thyroidectomy on patients with differentiated thyroid can-cer is ideal,which can improve the level of thyroid hormone and reduce the risk of short-term recurrence.

关 键 词：甲状腺全切除术 甲状腺激素 甲状腺近全切除术 分化型甲状腺癌 并发症 复发风险 

分 类 号：R735[医药卫生—肿瘤]