目的 研究放射性 ¹³¹I 在甲亢伴甲状腺结节中的应用价值。方法 纳入我院90例甲亢患者,根据其是否伴甲状腺结节分为无结节组(51例)、结节组(39例),均接受放射性 ¹³¹I 治疗。比较两组治疗总有效率,分析两组治疗前后血清甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)及游离甲状腺素(FT4)水平。结果 无结节组治疗总有效率74.51%,结节组为58.97%,差异无统计学意义(P＞0.05);两组治疗后TSH均高于治疗前(P＜0.05),FT3、FT4均低于治疗前(P＜0.05),TPOAb、TGAb较治疗前比较差异均无统计学意义(P＞0.05);无结节组治疗后FT3、FT4低于结节组(P<0.05),TPOAb、TGAb、TSH较结节组比较差异均无统计学意义(P＞0.05)。结论 放射性 ¹³¹I 治疗甲亢伴甲状腺结节效果好,且操作简单,副作用少,值得临床推广使用。

Objective To study the value of radioactivity ¹³¹I in hyperthyroidism with thyroid nodules. Methods Ninety patients with hyperthyroidism in our hospital were divided into non-nodule group (51 cases) and nodule group (39 cases) according to whether they had thyroid nodules or not. All patients received ¹³¹I radiation therapy. The total effective rate was compared between the two groups. The serum levels of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were analyzed before and after treatment. Results The total effective rate was 74.51% in non-nodule group and 58.97% in nodule group, with no significant difference (P>0.05);after treatment, TSH was higher in both groups than that before treatment (P<0.05), FT3 and FT4 were lower than that before treatment (P<0.05), TPOAb and TGAb had no significant difference compared with that before treatment (P>0.05);FT3 and FT4 in nodule-free group were lower than those in nodule group (P<0.05). TPOAb, TGAb and TSH had no significant difference compared with nodule group (P>0.05). Conclusion Radioactive ¹³¹I treatment of hyperthyroidism with thyroid nodules has good effect, simple operation and few side effects, which is worthy of clinical application.

目的 探讨不同甲状腺结节手术治疗方案的合理性及临床效果。方法 选取本院2018年1月—2019年1月收治的120例患有甲状腺结节患者为研究对象,将其随机分为A组和B组各60例,A组患者未进行甲状腺细针抽吸细胞学检查直接进行甲状腺结节切除手术,B组患者接受超声负压引导甲状腺细针抽吸细胞学检查后给予手术治疗方案,比较两组患者手术前、后良恶性结节患者变化、术后复发率、并发症发生率及手术疗效。结果 术后A组残余恶性结节患者比例高于B组(P=0.001),A组健康无结节病变患者占比低于B组(P=0.002),A组患者恶性结节复发率高于B组患者(P<0.05);两组术后并发症发生率无差异(P>0.05),A组手术治疗总有效率低于B组(P<0.05)。结论 甲状腺结节患者术前有效超声穿刺诊断、术中超声引导手术及术后抗癌化疗治疗方案可以提高甲状腺结节患者手术有效率,B组方案具有重要临床推广价值。

Objective To investigate the rationality and clinical effect of different thyroid nodules surgical treatment. Methods A total of 120 patients with thyroid nodules admitted to our hospital from January 2018 to January 2019 were randomly divided into group A and group B, respectively. Group A patients did not undergo fine needle extraction. Aspiration cytology was performed directly for thyroid nodule resection. Group B patients underwent ultrasound negative pressure guided thyroid fine needle aspiration cytology and were given surgical treatment. The changes of benign and malignant nodules before and after surgery were compared between the two groups including postoperative recurrence rate, complication rate and surgical outcome. Results The proportion of patients with residual malignant nodules in group A was higher than that in group B (P=0.001). The proportion of patients with healthy no-nodular lesions in group A was lower than that in group B (P=0.002). The recurred rate of malignant nodules in group A was higher than that of group B (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). The total effective rate of group A was lower than that of group B (P<0.05). Conclusion Preoperative effective ultrasound puncture diagnosis, intraoperative ultrasound guided surgery and postoperative anticancer chemotherapy treatment may improve the efficiency of thyroid nodules in patients with thyroid nodules. Group B has important clinical value.