摘要
目的探讨分化型甲状腺癌手术治疗后血清三碘甲状腺原氨酸(T3)、甲状腺激素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)和促甲状腺激素(TSH)水平随时间的变化及其对促甲状腺激素抑制治疗的指导价值。方法选取2012年1月至2017年12月于我院接受手术治疗的分化型甲状腺癌患者120例,依据手术方式的不同将患者分为甲状腺全切除组(n=55)和患侧腺叶及峡部切除组(n=65),于术后第1、2、4、6、8、14天检测2组患者T3、T4、FT3、FT4和TSH水平。结果甲状腺全切除组患者术后血清T3和FT3总体呈下降趋势,但术后第6天一过性增高,高于术后第4天水平,术后第14天血清T3和FT3低于正常参考范围。术后至第4天血清T4、FT4呈上升趋势,之后呈下降趋势,于术后第14天低于正常参考范围。血清TSH于术后第2天开始升高,于术后第6天超过正常参考范围,至术后第14天呈上升趋势。患侧腺叶及峡部切除组患者血清T3、FT3水平于术后第6天前呈下降趋势,术后第6天至14天呈上升趋势,第14天时其水平低于正常参考范围;血清T4、FT4于术后第2天达高峰后下降,术后第14天处于正常范围;术后血清TSH于术后4天内呈下降趋势,至术后第8天超过术前水平,术后第14天达正常参考值上限。结论分化型甲状腺癌手术治疗后其甲状腺相关激素呈动态变化规律,临床上应根据其变化规律确定促甲状腺激素抑制治疗时机。
Objective Our study was aimed to analyze the differentiated thyroid carcinoma of three iodine thyroid original glycine（T3）,thyroid hormone（T4） and free iodine thyroid original thyroid hormones（FT3） and free amino acid（FT4）,and thyroid stimulating hormone（TSH） level changes over time after thyroid cancer surgery and its guiding value of thyroid-stimulating hormone suppression therapy. Methods The clinical data of 120 cases of differentiated thyroid cancer patients undergoing surgical treatment admitted to our hospital from January 2012 to December 2017 were selected and divided into total thyroidectomy group（ n =55） and lateral adenoids and isthmic resection group（ n =65） according to the surgery method.Analyzed the T3,T4,FT3,FT4 and TSH levels in the first,2nd,4th,6th,8th and 14th days after surgery,and the guiding value for the treatment of thyroid suppression hormone. Results The serum T3 and FT3 in patients with total
thyroidectomy showed a decreasing trend after operation,but the 6th day was higher than the 4th day after surgery.The serum T3 and FT3 were lower than normal reference range in the 14th day after surgery.After surgery,T4 and FT4 showed an upward trend in the 4th day, followed by a downward trend,which was below the normal reference range in the 14th day after surgery.The serum TSH began to rise in the 2nd day after surgery,and exceeded the normal reference range for the sixth day after surgery,and increased in the 14th day after surgery.The serum levels of T3,FT3 had declined in 6 days,6 days to 14 days was on the rise,14 days the level was below the normal reference range in the side lobes and isthmic resection group.The serum T4 and FT4 decreased at postoperative 2 days,and was in normal range on the 14th day after surgery.The serum TSH showed a downtrend in 4 days after surgery,and exceeded the preoperative level on the 8th day,and reached the upper limit of normal reference value on the 14th day after surgery. Conclusion Hormones related the thyroid showed a dynamic change pattern after the operation in the differentiated thyroid carcinoma,and the timing of the treatment should be determined according to its change rule.
作者
方学庆
周立
唐民
FANG Xue-qing;ZHOU Li;TANG Min(Department of Minimally Invasive Surgery,People＇s Hospital of Chizhou,Chizhou Anhui 247000,China)
出处
《局解手术学杂志》
2018年第8期577-580,共4页
Journal of Regional Anatomy and Operative Surgery
关键词
分化型甲状腺癌
术后
激素水平
促甲状腺激素抑制治疗
differentiated thyroid cancer
postoperation
hormone levels
thyroid suppression hormone therapy
