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[放射性碘(131)治疗甲状腺乳头状癌合并终末期慢性肾衰竭患者的甲状腺残留组织]

[Treatment with (131)I of thyroid remnants in a patient with papillary thyroid carcinoma and end-stage chronic renal failure].

作者信息

Andres A, Tardín L, Santapau A, Razola P, Prats E, Parra A, Rivas M A, Ruiz P, Alvarez R, Camara A, Banzo J

机构信息

Servicio de Medicina Nuclear, Hospital Clínico Universitario "Lozano Blesa" de Zaragoza, Zaragoza, España.

出版信息

Rev Esp Med Nucl. 2010 Jan-Feb;29(1):32-5. doi: 10.1016/j.remn.2009.10.005. Epub 2009 Dec 16.

Abstract

The follow-up and treatment of thyroid cancer presents several aspects subject to discussion, such as its management in patients with End-Stage Renal Failure (ESRF). We present a patient with ESRF and papillary thyroid carcinoma, which had to be coordinated among different departments (Endocrinology, Nuclear Medicine, Nephrology and Physics and Radiation Protection). Both the diagnostic scintigraphy with (123)I and the ablative treatment with (131)I performed later were performed with the administration of rh TSH. The room in which the metabolic therapy was to be performed was prepared for the patient's periodic hemodialysis. The (131)I dose used was 80% of the usual dose. This made it possible to assure the therapeutic effect and that the patient's stay in hospital would only be for 5 days. Throughout the whole diagnostic and therapeutic process, no adverse effects attributable to rh TSH or radioiodine were observed. The coordination among the departments involved enabled an effective and safe process for the patient.

摘要

甲状腺癌的随访与治疗存在几个有待探讨的方面,比如其在终末期肾衰竭(ESRF)患者中的管理。我们报告了一名患有ESRF和乳头状甲状腺癌的患者,其诊疗需要不同科室(内分泌科、核医学科、肾内科以及物理与辐射防护科)之间进行协调。后来进行的(123)I诊断性闪烁扫描和(131)I消融治疗均在注射重组人促甲状腺素(rh TSH)的情况下进行。为患者定期血液透析准备了进行代谢治疗的房间。所使用的(131)I剂量为常规剂量的80%。这既保证了治疗效果,又使患者仅需住院5天。在整个诊断和治疗过程中,未观察到任何归因于rh TSH或放射性碘的不良反应。相关科室之间的协调为患者带来了有效且安全的诊疗过程。

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