刘 庆,杨华夏,史方富,刘志为,王春喜.甲状腺全切术治疗分化型甲状腺癌的疗效观察及临床研究探讨[J].,2018,(18):3576-3579 |
甲状腺全切术治疗分化型甲状腺癌的疗效观察及临床研究探讨 |
The Effect of Total Thyroidectomy in the Treatment of Differentiated Thyroid Carcinoma and Its Clinical Study |
投稿时间:2018-04-25 修订日期:2018-05-21 |
DOI:10.13241/j.cnki.pmb.2018.18.040 |
中文关键词: 甲状腺全切术 分化型甲状腺癌 肿瘤坏死因子-α 白细胞介素-6 半乳糖血凝素-3 血管内皮生长因子 |
英文关键词: Total thyroidectomy Differentiated thyroid carcinoma Tumor necrosis factor-α, Interleukin-6 Galectin-3 Vascular endothelial growth factor |
基金项目:海南省自然科学基金项目(2012-358) |
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中文摘要: |
摘要 目的:研究甲状腺全切术治疗分化型甲状腺癌的疗效观察及临床研究探讨。方法:收集2014年3月至2015年3月我院收治的90例分化型甲状腺癌患者,按抽签法分为实验组和对照组,每组45例。对照组采用次全切除术治疗,实验组采用甲状腺全切术治疗。观察两组患者的治疗疗效、手术时间、术中出血量、住院时间、复发率、治疗前后血清TNF-α、IL-6、Gal-3、VEGF水平及并发症的发生情况。结果:治疗后,实验组总有效率显著高于对照组[93.33%(42/45)vs68.89%(31/45)] (P<0.05)。两组住院时间比较差异无统计学意义(P>0.05),实验组手术时间、术中出血量、复发率均显著低于对照组[(70.36±12.72)min vs(109.75±15.37)min,(50.28±10.64)mL vs(91.62±13.50)mL,2.22%(1/45)vs15.56%(7/45)] (P<0.05);治疗后血清TNF-α、IL-6、Gal-3、VEGF水平均显著低于对照组[(506.30±78.23)pg/mL vs(621.25±83.54)pg/mL,(73.29±10.32)pg/mL vs(102.58±12.49)pg/mL,(3.40±0.80)ng/mL vs(4.82±0.81)ng/mL,(16.21±4.02)pg/mL vs(20.75±5.23)pg/mL] (P<0.05)。实验组和对照组并发症总发生率分别为15.56%、6.66%,两组比较差异无统计学意义(P>0.05)。结论:甲状腺全切术治疗分化型甲状腺癌的疗效优于次全切除术治疗,可彻底清除病灶,降低复发率,可能与有效降低患者血清TNF-α、IL-6、Gal-3、VEGF水平有关,但其并发症较多,对于低危或术后无需放射治疗的患者可采用次全切除术治疗,应慎重选择手术方式。 |
英文摘要: |
ABSTRACT Objective: To study the effect of total thyroidectomy in the treatment of differentiated thyroid carcinoma and its clini- cal study. Methods: 90 patients of differentiated thyroid carcinoma who were treated from March 2014 to March 2015 in our hospital were selected as the research objects, and divided into the experimental group and the control group according to the draw method, 45 cases in each group. The control group was treated with subtotal resection, while the experimental group was treated with total thyroidec- tomy. Then the treatment effect, operation index (operation time, intraoperative blood loss, hospital stay) and recurrence rate, the levels of serum TNF-α, IL-6, Gal-3, VEGF levels before and after treatment and the incidence of complications of two groups were compared. Results: After treatment, the total effective rate of experimental group was significantly higher than that of the control group[93.33%(42/45) vs.68.89%(31/45)](P<0.05). There was no difference in the hospital stay between the two groups(P>0.05), the operation time, intraopera- tive blood loss and recurrence rate of experimental group were significantly lower than those of the control group[(70.36±12.72)min vs. (109.75±15.37)min,(50.28±10.64)mL vs.(91.62±13.50)mL, 2.22%(1/45)vs15.56%(7/45)](P<0.05). After treatment, the serum TNF-α, IL-6, Gal-3, VEGF levels were significantly lower than those of the control group[(506.30±78.23)pg/mL vs. (621.25±83.54)pg/mL, (73.29±10.32)pg/mL vs. (102.58±12.49)pg/mL, (3.40±0.80)ng/mL vs. (4.82±0.81)ng/mL, (16.21±4.02)pg/mL vs. (20.75±5.23)pg/mL](P<0.05). The incidence of complications in the experimental group and the control group was 15.56%, 6.66%, there was no significant difference between the two groups(P>0.05). Conclusion: Total thyroidectomywas more effective for differentiated thyroid cancer than subtotal resection, it could completely clear the lesions and reduce the recurrence rate, which might be related to the decrease of serum TNF-α, IL-6, Gal-3 and VEGF levels, but there were many complications, and patients with low risk or no postoperative radia- tion therapy should be treated by subtotal resection. |
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