^(32)P胶体介入治疗甲状腺囊腺瘤临床分析

Clinical analysis of ^(32)P interventional treatment of thyroid adenoma

目的:探讨32P胶体联合地塞米松治疗甲状腺囊腺瘤的疗效。方法:收集自2008年1月至2012年5月于本院确诊的甲状腺囊腺瘤患者112例,全部患者随机分为两组:32P胶体联合地塞米松治疗组56例,32P胶体治疗组56例。患者治疗前后均查游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、血清促甲状腺素(TSH)、甲状腺球蛋白(TG)、甲状腺微粒体(TM)及血常规。用超声及甲状腺显像测量囊腺瘤大小。用药1个疗程之后,经医学影像检测未发现瘤体,则判定治愈;经医学影像检测发现囊腺瘤直径缩小超过1/2,则判定有效;经医学影像检测发现囊腺瘤缩小不到治疗前1/2或无变化,则判定无效。结果:两组的治疗疗效比较有显著差异(P<0.05)。两组治疗前后甲状腺激素及血常规检查未发现异常变化,穿刺液未检出癌细胞。治愈病例随访2年未复发。结论:32P胶体联合地塞米松治疗甲状腺囊腺瘤安全且无创,疗效确切,治愈率高,可避免手术损伤,值得临床推广应用。

Objective：To evaluate the efficacy of 32p combined with dexamethasone in treatment of cystic thyroid adenoma. Methods：All 112 patients that confirmed from 2008.1 -2012.5 were divided into treatment group（56 pa- tients） and control group（56 patients） randomly. Control group only used 32P,while the treatment group adopted 32p and dexamethasone. FT3, FT4, TSH, thyroglobulin （TG） , thyroid mierosomal （ TM ） and routine blood were measured and analyzed before and after treatment. Ultrasound and thyroid imaging were taken out to measure the size of cystic thyroid adenoma after 1 period of treatment. Curative ： No tumor was found by imageological examination. Effective ： The diameter of tumoer reduced more than 1/2. Invalid：The diameter of tumoer reduced less than 1/2 or unchanged. Re- suits：The efficacy showed significant change between 2 group（ P 〈 0.05 ）. Yet the level of thyroid hormones and rou- tine blood showed no significantly change after treatment. No cancer cells were detected in puncture fluid. No recur- rence was found after 2 - year follow - up in curative patients. Conclusion ：32p combined with dexamethasone in treat- ment of cystic thyroid adenoma was a safe and recommendable method with creditable efficacy and higher curative rate.