【摘要】 目的:探讨I131配合选择性颈淋巴结清除术治疗甲状腺癌(TC)的疗效和对患者唾液腺功能的影响。方法:选取2009年1月—2013年9月期间确诊治疗的TC患者60例,随机分均分为对照与观察组,对照组患者给予常规甲状腺切除术,观察组患者在此基础上给予选择性颈淋巴结清除术与I131治疗,其中又根据I131摄入量均分为高剂量亚组(3 500 m Bq)和低剂量亚组(1 000 m Bq),分析患者疗效和唾液腺功能指标及术后生存情况。结果:观察组首次清甲成功率与治疗总有效率均明显高于对照组(均P<0.05);唾液腺功能参数方面,手术组优于低剂量亚组,低剂量亚组优于高剂量亚组(均P<0.05);观察组中高、低剂量亚组5年生存率无明显差异,但均高于对照组(均P<0.05)。结论:I131配合选择性颈淋巴结清除术治疗可有效提高对TC手术患者的疗效并改善预后,虽有唾液腺功能方面不良反应,但低剂量治疗症状较轻,在患者接受范围内。更多还原

【Abstract】 Objective:To investigate the efficacy of concomitant I131 therapy following selective neck dissection in treatment of thyroid cancer(TC) and its inl uence on the salivary gland function of patients.Methods:Sixty TC patients admitted from January 2009 to September 2013 were selected,and were equally randomized into control group and observational group.Patients in control group underwent conventional thyroidectomy,while those in observational group received additional selective neck dissection and I131 therapy,and this group was further equally divided into high-(3 500 m Bq) and low-dose(1 000 m Bq) subgroup according to the I131 intake.The treatment efficacy,parameters for salivary gland function and postoperative survival of the patients were analyzed.Results:The initial ablation rate and overall effective rate in observational group were significantly higher thanthose in control group(both P<0.05); all parameters of salivary gland function in control group were better than those in low-dose subgroup,and in the latter were better than those in high-dose subgroup(all P<0.05).The 5-year survival rate showed no difference between high- and low-dose subgroup of observational group,but both were higher than that in control group(both P<0.05).Conclusion:Concomitant I131 therapy following selective neck dissection can ef ectively improve the surgical eifcacy and prognosis in TC patients,and although it exerts adverse ef ects on salivary gland function,the symptoms caused by low dose treatment are mild and are within the acceptable limits for the patients.更多还原