手術(shù)聯(lián)合131I、甲狀腺片治療甲狀腺乳頭狀癌療效觀察

危常鵬

摘要：目的 剖析甲狀腺乳頭狀癌用“手術(shù)+131I+甲狀腺片”療法的療效。方法 選擇2008年3月～2010年5月我院門診接診的甲狀腺乳頭狀癌病患64例，采用電腦隨機(jī)雙盲法，將64例入選病例隨機(jī)分成兩組：試驗(yàn)組、對照組各32例。試驗(yàn)組采取“手術(shù)+131I+甲狀腺片”療法，對照組采取手術(shù)療法。觀察兩組疾病復(fù)發(fā)情況，比較3及5年生存率。結(jié)果 試驗(yàn)組的3年生存率為100.0%，和對照組的93.75%比較更高，組間差異顯著（P<0.05）；實(shí)驗(yàn)組的5年生存率為96.87%，明顯高于對照組的84.37%，組間差異顯著（P<0.05）。試驗(yàn)組的疾病復(fù)發(fā)率為3.13%，對照組為15.63%。試驗(yàn)組明顯低于對照組組間差異顯著（P<0.05）。結(jié)論 甲狀腺乳頭狀癌手術(shù)治療時加用131I與甲狀腺片，可增強(qiáng)療效，降低疾病復(fù)發(fā)率，改善患者生存質(zhì)量。

關(guān)鍵詞：手術(shù)；甲狀腺乳頭狀癌；131I；生存率

Abstract：Objective To analyze the curative effect of papillary thyroid carcinoma surgery+131I+Thyroid Tablets therapy.Methods From March 2008～2010 year in May in our hospital admissions of papillary thyroid cancer in 64 cases，using the computer random double blind method，64 patients were randomly divided into two groups：experimental group and control group with 32 cases in each group.The experimental group was taken"Thyroid Tablets+131I+surgical therapy，the control group took the operation therapy.Observe two groups of disease recurrence，between 3 and 5 years survival rate.Results The 3 year survival rate of the experimental group was 100.0%，which was higher than 93.75% of the control group，and the difference between the two groups was significant（P<0.05）；the experimental group 5 years survival rate was 96.87%，significantly higher than 84.37% in the control group，significant difference between groups（P<0.05）.The experimental group of the disease recurrence rate was 3.13%，the control group 15.63%.The experimental group was significantly lower than the control group significantly（P<0.05）.Conclusion The surgical treatment of papillary thyroid carcinoma with 131I and Thyroid Tablets，can improve the curative effect，reduce the recurrence rate，improve the quality of life of patients.

Key words：Surgery；Papillary thyroid carcinoma；131I；Survival rate

臨床上，甲狀腺乳頭狀癌比較常見，可侵及病灶周圍的組織器官[1]，比如喉返神經(jīng)，氣管，帶狀肌，食管。現(xiàn)階段，隨著我國細(xì)胞穿刺技術(shù)以及彩超診斷技術(shù)的不斷發(fā)展與進(jìn)步，甲狀腺乳頭狀癌的診斷準(zhǔn)確率是越來越高。對此，我們還需加強(qiáng)對該疾病患者進(jìn)行臨床治療的力度，以幫助患者抑制病情進(jìn)展，提高生存質(zhì)量。有報道稱[2]，單純常規(guī)手術(shù)治療甲狀腺乳頭狀癌療效一般，術(shù)后復(fù)發(fā)率高，5年生存率低。本院自2008年3月起采取手術(shù)+131I+甲狀腺片的治療方式對甲狀腺乳頭狀癌病患進(jìn)行治療取得顯著成效，現(xiàn)作出如下報道。

1資料與方法

1.1一般資料 回顧性剖析2008年3月～2010年5月我院門診接收的64例甲狀腺乳頭狀癌病患的病歷資料，所有入選病例都于術(shù)前經(jīng)B超亦或者是CT檢查確診符合“甲狀腺乳頭狀癌臨床診斷標(biāo)準(zhǔn)[3]”，并自愿參與此次研究，簽署“手術(shù)知情同意書”。利用電腦隨機(jī)雙盲法，對64例入選病例進(jìn)行分組：試驗(yàn)組、對照組各有32例。當(dāng)中，試驗(yàn)組男性患者有13例，女性患者有19例；……