放射性131I治疗分化型甲状腺癌的临床效果及对患者唾液腺功能的影响.docVIP

放射性131I治疗分化型甲状腺癌的临床效果及对患者唾液腺功能的影响 　　[摘要]目的 对放射性131I治疗分化型甲状腺癌的临床效果进行评价及分析，并探讨放射性131I治疗对患者唾液腺功能的影响情况。方法 选取2012年1月～2016年1月在我院行放射性131I治疗的86例分化型甲状腺癌患者作为研究对象，进行回顾性分析。治疗前利用唾液腺动态显像同时了解甲状腺残余组织的大小和唾液腺功能，治疗后3～6个月131I全身显像用于评价清除残余甲状腺（清甲）效果，利用唾液腺动态显像分析计算腮腺和颌下腺在服用131I前及服治疗量131I后10 d、1个月、3个月的最大浓聚率（MAR）以及酸刺激后最大分泌率（MSR）。结果 86例患者中，完全清除61例，占70.93%；不完全清除25例，占29.07%。95处转移灶共治愈42处，占44.21%；有效32处，占33.68%；无效21处，占22.11%。腮腺MAR和MSR在131I治疗10 d和1个月后均较首次131I治疗前明显降低（P0.05），至治疗3个月后其恢复正常。颌下腺MAR在131I治疗10 d后出现明显下降（P0.05），MSR在131I治疗1个月后出现明显下降（P0.05）。治疗后随访发现，未出现唾液腺功能永久性严重受损患者。结论 应用放射性131I治疗分化型甲状腺癌对于清除残留甲状腺组织是一种安全且有效的方法，放射性131I治疗可在短期内导致唾液腺功能损伤，其具有可逆性，于3个月内恢复正常。 　　[关键词]分化型甲状腺癌；放射性131I治疗；清甲治疗；唾液腺功能 　　[中图分类号] R736.1 [文献标识码] A [文章编号] 1674-4721（2016）07（b）-0078-03 　　[Abstract]Objective To evaluate and analyze the clinical effect of radioactive iodine 131I in the treatment of differentiated thyroid carcinoma and study the effect of radioactive iodine 131I on the function of salivary gland.Methods 86 patients with differentiated thyroid carcinoma were selected as the object of study and treated in our hospital from January 2012 to January 2016.The size of residual thyroid tissue and the function of salivary gland were measured by salivary gland dynamic imaging before treatment.Effect of removing the residual thyroid gland were evaluated by 131I whole body imaging after 3-6 months treatment.The maximum accumulation rate （MAR） and maximum secretion rate （MSR） of parotid and submandibular gland before using 131I and at 10 days，1 month and 3 months after using 131I were measured by salivary gland scintigraphy.Results Among 86 cases，61 cases were completely removed，accounting for 70.93%.25 cases were not completely removed，accounting for 29.07%.42 out of 95 metastatic lesions were cured，accounting for 44.21%，32 were effective，accounting for 33.68%，and 21 were invalid，accounting for 22.11%.MAR and MSR of parotid gland were significantly decreased at 10 days and 1 month after using 131I compared to those before u