| Objective:This paper aims to review and analyze 230 patients after thyroid carcinoma operation cured in Nuclear Medicine of our hospital from January 1 to December,2015.131 I first radiotherapy is used to remove post-operation residual thyroid tissues,to observe its curative effect and probe into factors influencing 131 I thyroidectom after DTC operation.Method:230 DTC patients cured in Nuclear Medicine of our hospital from January,2011 to December,2015 are selected both for first 131 I thyroidectom after DTC operation.The low-risk group of DTC patients are dosed 131 I of 1.85 to 3.7 GBq(50-100mci)and the moderately high risk group of patients are dosed 131 I of 3.7 to 7.4 GBq(100-200mci).Classifying according to sex,age,pathological pattern,surgical approach,weight of residual thyroid,pre-treatment Tg level,131 I therapeutic dose and capsular infiltration or not,it is to observe the curative effect of residual thyroid tissue after 131 I operation and study factors influencing curative effect of thyroidectom operation.It is to evaluate whether thyroidectom is successful after six months and medication of levothyroxine shall be stopped for three to four weeks before follow-up visit.Operate 131 whole body imaging and measuring serum Tg,then judge 131 I thyroidectom effect after DTC operation according to thyroidectom success standards recommended by Guidance for 131I Treatment of DTC(briefly called China G.uidance established by CSNM in 2014.Standards of thyroidectom success:1.After TSH stimulation,no imaging of thyroid bed area under 131 I whole body imaging,2.The stimulation Tg is less than Lug(L)after stopping medication of levothyroxine,it is considered of thyroidectom being successful if one of the above-mentioned situations exists.According to materials obtained:(1)by calculating success rate of 131 I first thyroidectom;(2)by comparing difference among various above-mentioned indexes of successful and unsuccessful groups of first thyroidectom operation,it is to study factors influencing curative effect of thyroidectom.Results:there are 141 cases of successful first thyroidectom operation among 230 cases of DTC patients,the success rate is 61.3%,89 cases of unsuccessful operation.accounting for 38.7%.It is showed through check analysis of single factor X2 that:(1)grouping according to the median Tg level before treatment,the group of s Tg less than or equal to the median group is compared with the group more than the median group,the success rate of s Tg less than or equal to the median group is 80.5%,which is Significantly higher than 17.6%of success rate of the group of s Tg less than or equal to the median group.The difference is of statistical significance(80.5%more than 17.6%,P<0.01).(2)there are a total of 143 cases of total thyroidectom,122 cases of successful thyroidectom,with 85.3%success rate,87 cases of sub-total thyoidectom,18 cases of successful thyoidectom,with 20.6%success rate.The difference among groups has statistical significance(P<0.05),which shows that patients accepting total thyroidectom have higher success probability of first thyroidectom.(3)group cases after DTC operation into four based on weight of residual thyroid.After comparison among groups,it is found that the little the residual thyroid is,the higher success rate of thyroidectom operation.The difference is of statistical significance.(P<0.05)After logistich regression analysis,the results show that,surgical approach,size of residual thyroid and Tg level before operation are main influencing factor of 131 I thyroidectom operation,with little influence from sex,age,capsular infiltration,pathological pattern and 131 I treatment dosage.Conclusion(1)the curative effect of 131 I first thyroidectom for DTC patients is obvious,with about 61.3%success rate,is a safe and effective method.(2)the curative effect of 131 I treating residual thyroid tissue after DTC operation mainly depends on surgical approach,size of residual thyroid and Tg level before treatment. |
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