甲状腺癌颈侧区淋巴结清扫术后甲状腺球蛋白和甲状腺球蛋白抗体水平的变化
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摘要
目的探讨甲状腺癌颈侧区淋巴结清扫术后甲状腺球蛋白(Tg)和甲状腺球蛋白抗体(TgAb)水平的变化。方法选取2016年1月至2018年6月间南方医科大学深圳医院收治的182例甲状腺癌患者,采用数表法随机分为研究组和对照组,每组91例。研究组患者采用颈侧区淋巴结清扫术治疗,对照组患者采用常规甲状腺切除术治疗。比较两组患者治疗前后Tg、TgAb和甲状腺功能水平及临床疗效。结果术后,研究组患者促甲状腺素、三碘甲腺原氨酸、游离三碘甲腺原氨酸、甲状腺素和游离甲状腺素等甲状腺功能水平均低于对照组患者,差异均有统计学意义(均P <0. 05)。相比术前,两组患者术后3个月和6个月的Tg和TgAb水平均下降,且研究组低于对照组,差异均有统计学意义(均P <0. 05)。研究组患者的临床疗效为94. 5%(869列),高于对照组患者的72. 5%(66例),差异有统计学意义(P <0. 05)。结论颈侧区淋巴清扫术与传统手术相比,可改善机体甲状腺功能,调节Tg和TgAb水平表达,疗效显著,值得临床推广。
Objective To analyze the changes in thyroglobulin( Tg) and thyroglobulin antibody( TgAb) levels after lateral neck dissection in thyroid cancer. Methods A total of 182 patients with thyroid cancer admitted to Shenzhen Hospital,Southern Medical University from January 2016 to June 2018 were selected and randomly divided into a study group and a control group with 91 patientsvin each group. The study group was treated with lateral neck dissection and the control group received conventional thyroidectomy. Tg and TgAb levels,thyroid function and the clinical treatment efficacy were compared before and after the treatment between the two groups. Results After the surgery,the thyroid function including thyroid stimulating hormone( TSH),triiodothyronine( T3),free triiodothyronine( FT3),thyroxin( T4),and free thyroxin( FT4) were significantly lower in the study group than in the control group( all P < 0. 05). Compared with the preoperative,the Tg and TgAb levels were significantly decreased at 3 and 6 months after the operation with the study group lower than the control group( all P < 0. 05). The clinical efficacy was94. 5% in the study group( 86 patients) which was higher than 72. 5% of the control group( 66 patients)( P < 0. 05). Conclusion Compared with traditional surgery,lateral neck dissection can improve thyroid function and regulate the expression of Tg and TgAb. The curative efficacy is significant and worthy of clinical promotion.
Objective To analyze the changes in thyroglobulin( Tg) and thyroglobulin antibody( TgAb) levels after lateral neck dissection in thyroid cancer. Methods A total of 182 patients with thyroid cancer admitted to Shenzhen Hospital,Southern Medical University from January 2016 to June 2018 were selected and randomly divided into a study group and a control group with 91 patientsvin each group. The study group was treated with lateral neck dissection and the control group received conventional thyroidectomy. Tg and TgAb levels,thyroid function and the clinical treatment efficacy were compared before and after the treatment between the two groups. Results After the surgery,the thyroid function including thyroid stimulating hormone( TSH),triiodothyronine( T3),free triiodothyronine( FT3),thyroxin( T4),and free thyroxin( FT4) were significantly lower in the study group than in the control group( all P < 0. 05). Compared with the preoperative,the Tg and TgAb levels were significantly decreased at 3 and 6 months after the operation with the study group lower than the control group( all P < 0. 05). The clinical efficacy was94. 5% in the study group( 86 patients) which was higher than 72. 5% of the control group( 66 patients)( P < 0. 05). Conclusion Compared with traditional surgery,lateral neck dissection can improve thyroid function and regulate the expression of Tg and TgAb. The curative efficacy is significant and worthy of clinical promotion.
引文
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[6]杜江,钟红,博格拉·阿尔斯兰,等.血清促甲状腺激素水平对甲状腺乳头状癌颈侧淋巴结转移诊断作用分析[J].中国肿瘤临床与康复,2017,24:129-131.
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[8]姚礼,严轶群,汪加宽,等.甲状腺癌颈侧区淋巴结清扫术后甲状腺功能、甲状腺球蛋白抗体、甲状腺球蛋白的变化[J].实用临床医药杂志,2018,22:60-62.
[2]范文涛,宇雪豹,柯和平,等.甲状腺癌颈部转移性淋巴结的超声诊断分析[J].中国肿瘤临床与康复,2017,24:1067-1070.
[3]张波,徐景竹,吴琼. 2015年美国甲状腺学会《成人甲状腺结节与分化型甲状腺癌诊治指南》解读:超声部分[J].中国癌症杂志,2016,26:19-24.
[4]龚茂松,丛伟,郝战宇,等.腔镜辅助与传统手术在甲状腺癌颈侧区淋巴结清扫术中的效果比较[J].山东医药,2016,56:107-108.
[5]方鸿,周梦默,王晶晶,等.甲状腺微小乳头状癌的二维超声特征[J].实用临床医药杂志,2017,21:121-122.
[6]杜江,钟红,博格拉·阿尔斯兰,等.血清促甲状腺激素水平对甲状腺乳头状癌颈侧淋巴结转移诊断作用分析[J].中国肿瘤临床与康复,2017,24:129-131.
[7]王卓颖,郭凯.甲状腺癌功能性颈淋巴结清扫术[J].中国实用外科杂志,2017,37:1057-1059.
[8]姚礼,严轶群,汪加宽,等.甲状腺癌颈侧区淋巴结清扫术后甲状腺功能、甲状腺球蛋白抗体、甲状腺球蛋白的变化[J].实用临床医药杂志,2018,22:60-62.