甲状旁腺自体移植术联合甲状腺全切术治疗甲状腺癌的临床研究

Clinical Study of Parathyroid Autotransplantation Combined with Total Para-thyroidectomy in Treatment of Thyroid Cancer

目的:探讨甲状旁腺自体移植术(AT)联合甲状腺全切术(TPTX)治疗甲状腺癌的临床疗效。方法:将2020年1月-2021年6月于徐州市肿瘤医院就诊的66例甲状腺癌患者作为研究对象,按照随机数表法分为研究组与对照组,各33例。对照组患者行TPTX治疗,研究组患者在对照组基础上联合AT治疗。比较两组患者手术前后的临床症状及体征改善情况、甲状腺功能。结果:研究组患者手术后的感觉异常、指/肢端麻木及焦虑发生率均显著低于对照组,血清甲状腺过氧化物酶抗体、甲状腺球蛋白抗体、低甲状腺激素水平均显著低于对照组,游离三碘甲状腺原氨酸、游离四碘甲状腺原氨酸水平显著高于对照组,差异有统计学意义(P<0.05)。研究组患者术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:AT联合TPTX治疗可有效减轻甲状腺癌患者术后的临床症状及体征,增强患者术后甲状腺免疫抗体,改善甲状腺功能,临床疗效确切,并发症发生率低,安全性较高。

Objective:To investigate clinical efficacy of parathyroid autotransplantation(AT)combined with total para thyroidectomy(TPTX)in treatment of thyroid cancer.Methods:Sixty-six patients with thyroid cancer treated in Xuzhou Cancer Hospital from January 2020 to June 2021 were selected as the study objects and divided into study group and control group using random number table method,with 33 cases in each group.The patients in the control group were treated with TPTX,and the patients in the study group were treated with AT on the basis of the control group.The improvements of clinical symptoms and signs,as well as thyroid function of the two groups before and after operation were compared.Results:The incidence of sensory abnormalities,finger/limb numbness and anxiety in the study group were significantly lower than those in the control group,and the levels of serum TPOAb,TGAb and TSH were significantly lower than those in the control group,the levels of FT3 and FT4 were significantly higher than those in the control group,with statistically significant difference(P<0.05).The incidence of postoperative complications in the study group was significantly lower than that in the control group,with statistically significant difference(P<0.05).Conclusion:AT combined with TPTX can effectively reduce the postoperative clinical symptoms and signs of patients with thyroid cancer,enhance the postoperative thyroid immune antibody and improve their thyroid function.It has definite clinical curative effect,low complication rate and high safety.