中国普外基础与临床杂志

中国普外基础与临床杂志

育龄期女性甲状腺乳头状癌碘 131 治疗后月经节律及生育情况的随访与评价

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目的 探讨甲状腺乳头状癌(PTC)全切除术后行碘 131 治疗对女性患者月经及生育的影响。 方法 回顾性分析 2007 年 1 月至 2016 年 12 月期间在新疆医科大学第一附属医院血管甲状腺外科行甲状腺全切除术治疗的 342 例育龄期(20~40 岁)女性 PTC 患者的临床资料,按照术后是否实施了碘 131 治疗将患者分为碘 131 治疗组(126 例)和非碘 131 治疗组(216 例),定期随访患者术后月经节律及妊娠情况。用两独立样本 t 检验、χ2 检验对 2 组患者的年龄、民族、职业、月经节律情况及妊娠情况进行对比分析。 结果 ① 碘 131 治疗组与非碘 131 治疗组患者在年龄、民族及职业的分布方面比较差异均无统计学意义(P>0.05)。② 碘 131 治疗后第 1 个月和第 3 个月时碘 131 治疗组月经不规律患者所占比例明显高于非碘 131 治疗组(P<0.05), 碘 131 治疗后第 6 个月及第 12 个月时 2 组月经不规律患者所占比例比较差异均无统计学意义(P>0.05);进一步的年龄分层分析结果发现,2 组月经不规律患者所占比例比较差异均无统计学意义(P>0.05)。③ 无论是从 53 例有妊娠计划和意愿总体患者还是年龄分层分析结果均未发现碘 131 治疗组与非碘 131 治疗组患者的妊娠结局比较差异有统计学意义(P>0.05)。 结论 PTC 术后碘 131 治疗在早期(6 个月内)会对育龄期女性的月经节律有一定的影响,6 个月后月经节律基本无异常;其对育龄期女性的妊娠也无明显影响,但仍建议在治疗后 1 年再接受妊娠。

Objective To investigate influence of iodine-131 treatment following total thyroidectomy on menstruation and fertility of childbearing age patients with papillary thyroid carcinoma (PTC). Methods The clinical data of 342 childbearing age patients with PTC treated with total thyroidectomy from January 2007 to December 2016 in the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. The patients were designed to iodine-131 treatment group (126 cases) and non-iodine-131 treatment group (216 cases) according to the postoperative treatment. The menstrual rhythm and pregnancy after operation were regularly followed-up. The age, nationality, occupation, menstrual rhythm, and pregnancy were analyzed by two independent samples t test or chi-square test. Results ① There were no statistical significant differences in the age, race, and occupation between the iodine-131 treatment group and the non-iodine-131 treatment group (P>0.05). ② Compared with the non-iodine-131 treatment group, the proportions of the irregular menstruation were statistically significantly increased on the 1st and 3rd after the iodine-131 treatment (P<0.05), which had no statistically significant differences on the 6th and 12th months after the iodine-131 treatment (P>0.05) in the iodine-131 treatment group. Further the analysis results of the age stratification showed that had no statistically significant differences at different time after the iodine-131 treatment in these two groups (P>0.05). ③ The success rate of pregnancy also had no statistically significant differences in these two groups both in the general and the age stratification analysis results (P>0.05). Conclusions Iodine-131 treatment following total thyroidectomy can affect menstrual rhythm of women in childbearing age at the early stage (within 6 months), but there is no abnormal menstruation rhythm on 6 months after iodine-131 treatment, which dosen’t effect on pregnancy in women of childbearing age, and it is recommended that pregnancies be renewed in 1-year after iodine-131 treatment.

关键词: 甲状腺乳头状癌; 碘 131 治疗; 育龄期女性; 妊娠

Key words: papillary thyroid carcinoma; iodine-131 treatment; childbearing age women; pregnancy

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