HCT患者实施全切术结合^(131)I清甲治疗的临床疗效及安全性

Clinical efficacy and safety of total thyroidectomy combined with ^(131)I radioiodine therapy for patients with hurthle cell thyroid cancer

目的探讨甲状腺嗜酸细胞肿瘤(HCT)患者行甲状腺全切术结合131Ⅰ清甲治疗的临床疗效及安全性。方法选取2001年1月至2013年1月我院收治的20例HCT患者为研究对象。所有患者行甲状腺全切术结合131Ⅰ清甲治疗,观察其治疗后的并发症、甲状腺旁功能减退情况和肿瘤复发情况等。结果 HCT患者实施全切术结合131Ⅰ清甲治疗总有效率100%,未出现声嘶、感染等并发症,随访未发现肿瘤复发或死亡;甲状腺全切术联合中央区淋巴结清扫术使甲状旁腺损伤的概率增加;单纯甲状腺全切术和甲状腺全切术联合中央区淋巴结清扫术的患者在131Ⅰ治疗不同阶段,PTH水平差异无统计学意义(P>0.05)。结论单纯甲状腺全切术结合131Ⅰ清甲治疗使甲状旁腺损伤的概率较小,损伤也仅为暂时性甲状旁腺功能减低,多为1个月内恢复,安全性高。

Objective To investigate the clinical efficacy and safety of total thyroidectomy combined with ^131I radioiodine therapy for patients with hurthle cell thyroid cancer（ HCT）. Methods From January 2001 to January 2013,20 HCT patients in our hospital,who underwent total thyroidectomy combined with ^131I radioiodine therapy. The complications,the thyroid dysfunction and tumor recurrence were observed. Results The total efficiency of patients received total thyroidectomy combined with ^131I radioiodine therapy was 100%,with no hoarseness,infection and other complications. And there was no tumor recurrence or death during follow-up. Total thyroidectomy combined with central lymphadenectomy had increased the chance of injury of parathyroid. There was no significant differences of PTH levels between simple thyroidectomy and total thyroidectomy combined with central lymphadenectomy in patients with different stages of treatment in131Ⅰtreatment（ P 〉0. 05）. Conclusion Simple thyroidectomy combined with ^131I radioiodine therapy causes less chance of injury of parathyroid that restored within a month,which is high safety.