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目的探讨碘-131(131I)治疗分化型甲状腺癌(DTC)辐射并发症的预防与处置方法。方法选择经手术后病理确诊并完成131I治疗的DTC患者100例,其中男22例,女78例,年龄9~75岁。在131I治疗实施期间先采取预防措施;对发生的并发症进行诊断处理,对照疗效,建立辐射并发症的解决方案。结果 100例患者的298次131I治疗中发生各种辐射并发症199例次,占全部治疗次数的68.9%(199/289)。其中局部辐射反应最常见,共发生141例次,占全部并发症的70.9%(141/199),而大部分(100/141)发生于第一次治疗中;放射性胃炎发生31例次,占15.6%(31/199);涎腺炎发生22例次,占11.1%(22/199);骨髓一过性抑制发生4例次,占2.0%(4/199);放射性皮炎发生1例,占0.5%(1/199),此例患者疼痛剧烈。以上辐射并发症经处理后均痊愈。其他并发症在本组病例中未发生。预防与准备均在治疗前、中实施。结论 131I治疗DTC确有辐射并发症发生,多数症状轻微,对症处理后能够很快缓解痊愈。严重并发症发生的几率小,但起病重,预防是关键。如有发生,则应及时诊治,不使其发生严重后果。
Objective To investigate the prevention and treatment of iodine-131 (131I) in the treatment of radiation-induced complications of differentiated thyroid cancer (DTC). Methods Totally 100 DTC patients diagnosed by pathology and completed 131I treatment, including 22 males and 78 females, aged 9-75 years. 131I treatment in the implementation of the first take preventive measures; diagnosis and treatment of complications occurred, control efficacy, the establishment of radiation complications solution. Results A total of 199 radiotherapy complications occurred in 298 131I treatments of 100 patients, accounting for 68.9% (199/289) of the total number of treatments. The most common local radiation reaction was 141 cases, accounting for 70.9% (141/199) of the total complications, most of them (100/141) occurred in the first treatment; radioactive gastritis occurred in 31 cases, accounting for 15.6% (31/199); sialadenitis 22 cases, accounting for 11.1% (22/199); bone marrow transient inhibition occurred in 4 cases, accounting for 2.0% (4/199); radiodermatitis in 1 case, Accounting for 0.5% (1/199), the patient had severe pain. The above radiation complications were cured after treatment. Other complications did not occur in this group of patients. Prevention and preparation are implemented before and during treatment. Conclusion 131I treatment of DTC does have radiation complications, most of the symptoms are mild, symptomatic treatment can quickly relieve recovery. The risk of serious complications is small, but the onset of weight, prevention is the key. If there is any, it should be timely diagnosis and treatment, without serious consequences.