甲状腺乳头状癌术后患者1例左甲状腺素剂量调整分析

Analysis the dose adjustment of levothyroxine for a postoperative patient with papillary thyroid carcinoma

目的探讨临床药师参与甲状腺癌术后患者左甲状腺素替代治疗剂量调整的作用。方法临床药师综合评估1例甲状腺乳头状癌术后患者死亡危险度和复发危险度后,对患者左甲状腺素替代剂量提出调整建议,并为患者制定药学监护计划。结果与结论患者左甲状腺素片剂量减少至225μg,qd,从而在保证促甲状腺激素得到充分抑制不使肿瘤复发的同时,纠正患者轻微的甲状腺功能亢进病情,体现了临床药师在甲状腺癌术后左甲状腺素替代治疗上的临床价值。

Objective To investigate the role of pharmacists participating in the dose adjustment of levothyroxine in replacement therapy for a postoperative patient with papillary thyroid carcinoma. Methods The pharmacist evaluated the risk of death and recurrence of the postoperative patient with papillary thyroid carcinoma comprehensively,made an advice on the levothyroxine dose adjustment,and made pharmaceutical care plan for the patient. Result and conclusion The dose of levothyroxine was decreased to 225 μg,qd,in order to fully inhibit the thyroid stimulating hormone to avoid tumor recurrence and meanwhile to correct the patient＇s mild hyperthyroidism. This indicated the value of clinical pharmacists in levothyroxine replacement therapy after operation of thyroid carcinoma.