手术联合~(131)I治疗分化型甲状腺癌疗效探讨

目的探讨手术联合131I对分化型甲状腺癌的治疗效果。方法将160例分化型甲状腺癌(DTC)患者根据术后是否接受131I治疗分为观察组与对照组各80例。观察组给予手术+放射性131I治疗,对照组给予手术+优甲乐治疗,观察两组治疗情况。结果观察组首次"清甲"成功率为71.3%,甲状腺全切者首次"清甲"成功率显著高于次全切者(P<0.01)。术后131I治疗对颈部淋巴结转移患者总有效率为95.3%,肺转移患者为82.6%,骨转移患者为64.3%。服用131I后1周内不良反应发生率为38.8%(31/80),其中甲状腺全切者不良反应发生率显著低于次全切者(P<0.05)。随访至今,观察组复发转移发生率与患者存活率均显著优于对照组(P<0.05)。结论手术+131I治疗DTC可在术后有效清除残留甲状腺组织及残留的微小癌,同时可对颈部淋巴结转移及肺转移灶进行治疗,可降低复发及转移率,远期效果较好。

Effect of thyroidectomy combined with 131I therapy on patients with differentiated thyroid carcinoma

Objective To discuss the clinical effect of thyroidectomy combined with 131I therapy on patients with differentiated thyroid carcinoma(DTC). Methods 160 patients with DTC were divided into observation group(80 cases) and control group(80 cases),observation group were given thyroidectomy combined with 131I therapy,but the control group were given thyroidectomy combined with euthyrox therapy,then we contrasted the clinical effects between the two groups. Results The initial ablation was 71.3% in observation group,the initial ablation rate of patients undergone total thyroidectomy was significantly higher than subtotal thyroidectomy(P<0.01).The total effective rate of 131I therapy after thyroidectomy was 95.3% in cervical lymph node metastases,82.6% in pulmonary metastasis,64.3% in bone metastasis.The adverse reaction rate 1 week after 131I therapy was 38.8%(31/80),and it was significantly lower in the patients undergone total thyroidectomy than subtotal thyroidectomy(P<0.05).Follow-up so far,the recurrence,metastasis,and survival rate of the observation group was significantly better than the control group(P<0.05). Conclusion 131I therapy in patients with DTC can remove residual thyroid tissue and small cancer effectively after thyroidectomy,and treat cervical lymph node metastasis and pulmonary metastases at the same time and reduce the recurrence and metastasis rate.Thyroidectomy combined with 131I therapy has better long-term effect.