放射性药物^(131)I联合手术治疗分化型甲状腺癌的临床疗效

Clinical efficacy of radioactive drug ^(131)I combined with surgical treatment for I differentiated thyroid cancer

目的探讨放射性药物^(131)I联合手术治疗分化型甲状腺癌的临床疗效。方法根据治疗方式的不同将113例分化型甲状腺癌患者分为切除组(n=54)和放射组(n=59),切除组患者接受甲状腺全切术或次全切除术,放射组患者在手术切除的基础上联合放射性药物131I清甲治疗。比较两组患者临床疗效、唾液腺功能指标(唾液初始pH值、唾液缓冲pH值、唾液流率)、甲状腺激素[甲状腺球蛋白(Tg)和甲状腺球蛋白抗体(TgAb)]水平及不良反应发生情况。结果放射组患者的治疗总有效率为96.61%,明显高于切除组患者的74.07%,差异有统计学意义(P﹤0.01)。治疗后,两组患者唾液初始pH值、唾液缓冲pH值均高于本组治疗前,唾液流率均低于本组治疗前,放射组患者唾液初始pH值、唾液缓冲pH值均高于切除组,唾液流率低于切除组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者Tg、TgAb水平均低于本组治疗前,且放射组患者Tg、TgAb水平均低于切除组,差异均有统计学意义(P﹤0.05)。放射组患者的不良反应总发生率为16.95%,与切除组患者的14.81%比较,差异无统计学意义(P﹥0.05)。结论放射性药物^(131)I联合手术治疗甲状腺癌,可提高临床疗效,改善甲状腺激素水平,且安全性较好。

Objective To explore the clinical efficacy of radioactive drug ^(131)I combined with surgical treatment for dif-ferentiated thyroid cancer.Method According to different treatment methods,113 patients with differentiated thyroid cancer were divided into resection group(n=54)and radiation group(n=59).Patients in the resection group underwent to-tal or subtotal thyroidectomy,while patients in the radiation group received radioactive drug ^(131)I combined with total or subtotal thyroidectomy.The clinical efficacy,salivary gland function indicators(initial salivary pH value,salivary buffer pH value,salivary flow rate),thyroid hormone levels[thyroglobulin(Tg),thyroglobulin antibody(TgAb)],and incidence of adverse reactions were compared between the two groups.Result The total effective rate of radiation group was 96.61%,which was higher than 74.07%of the resection group,and the difference was statistically significant(P<0.01).After treatment,the initial salivary pH value and salivary buffer pH value in the two groups were higher than those before treatment,the salivary flow rates were lower than those before treatment,the initial salivary pH value and salivary buffer pH value in the radiation group were significantly higher than those in the resection group,and the salivary flow rate was significantly lower than that in the resection group,and the differences were statistically significant(P<0.05).After treat-ment,the Tg and TgAb levels in both groups were lower than those before treatment,and the Tg and TgAb levels in the radiation group were lower than those in the resection group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the radiation group was 16.95%,which was not statistically significant com-pared to 14.81%in the resection group(P>0.05).Conclusion The combination of radioactive drug ^(131)I and surgical treat-ment for differentiated thyroid cancer can improve clinical efficacy,thyroid hormone levels,and have good safety.