CAJ | 학술논문

目的：观察分化型甲状腺癌术后首次131碘清除剩余甲状腺组织（“清甲”）的效果并对其影响因素进行分析。方法分化型甲状腺癌术后患者65例，分别依据患者年龄、性别、病理类型、摄131碘率高低、清甲治疗后行单光子发射型计算机断层（SPECT）检查有无剩余甲状腺外转移灶及术后到首次131碘“清甲”间隔时间进行分组，131碘“清甲”剂量为3.7～7.4 GBq，治疗后3个月行颈部131碘扫描，以及摄碘率检查，以甲状腺床摄131碘率＜1%，诊断剂量SPECT131碘显像无甲状腺组织显影，为清除成功标准。结果65例病人中成功清除者50例，首次131碘“清甲”成功率76.92%。患者年龄、性别及病理类型均不影响首次131碘“清甲”效果；摄碘率的高低、“清甲”治疗后SPECT检查有剩余甲状腺外转移灶以及术后到首次131碘“清甲”间隔时间对首次131碘“清甲”效果影响较大。结论分化型甲状腺癌患者手术治疗以甲状腺全切为首选，摄碘率低清甲效果好，首次“清甲”应在术后3个月内进行。
목적：관찰분화형갑상선암술후수차131전청제잉여갑상선조직（“청갑”）적효과병대기영향인소진행분석。방법분화형갑상선암술후환자65례，분별의거환자년령、성별、병리류형、섭131전솔고저、청갑치료후행단광자발사형계산궤단층（SPECT）검사유무잉여갑상선외전이조급술후도수차131전“청갑”간격시간진행분조，131전“청갑”제량위3.7～7.4 GBq，치료후3개월행경부131전소묘，이급섭전솔검사，이갑상선상섭131전솔＜1%，진단제량SPECT131전현상무갑상선조직현영，위청제성공표준。결과65례병인중성공청제자50례，수차131전“청갑”성공솔76.92%。환자년령、성별급병리류형균불영향수차131전“청갑”효과；섭전솔적고저、“청갑”치료후SPECT검사유잉여갑상선외전이조이급술후도수차131전“청갑”간격시간대수차131전“청갑”효과영향교대。결론분화형갑상선암환자수술치료이갑상선전절위수선，섭전솔저청갑효과호，수차“청갑”응재술후3개월내진행。
Objective To observe the effect of first time radioactive iodine (131I) ablation on residual thyroid tissue of differentiated thyroid carcinoma (DTC) post-operation and to analyze influence factors. Methods A total of 65 cases of DTC cancer were included in the study. After processed with Single-photon emission computed tomography (SPECT) after 131I ablation according to the age, gender, pathological type and intake rate of 131I, the patients were divided based on presence of residue thyroid metastasis and the interval time from post-operation to first time 131I ablation. The dosage of 131I ablation was ranged from 3.7 to 7.4 GBq and the neck scan with 131I and intake rate of 131I were performed 3 months later. The intake rate of 131I in thyroid bed<1%and no thyroid tissue shadow after diagnosis dosage of 131I by SPECT were used as the successful eradiation criteria. Results Fifty out of sixty-five patients were confirmed with successful eradiation, the success rate of first time 131I ablation was 76.92%. No difference was found after comparison with the age, gender and pathological type. The intake rate of 131I, presence of residue thyroid metastasis, and the interval time from post-operation to first time 131I ablation possessed a significant impact on 131I ablation. Conclusion The total thyroidectomy is the first choice for the patients with DTC. Low rate of 131I intaking extend a good effect for ablation and the first 131I ablation should be performed within 3 month post-operation.