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[关于¹³¹I治疗甲状腺毒症和甲状腺癌的共识建议]

[Consensus proposal on the use of 131I in the treatment of thyrotoxicosis and thyroid cancer].

作者信息

Michaud P

机构信息

Sociedad Chilena de Endocrinología y Metabolismo, Hospital Dr Sótero del Río, Santiago, Chile.

出版信息

Rev Med Chil. 1998 Jul;126(7):855-65.

PMID:9830780
Abstract

A consensus meeting held by the Chilean Endocrinological Society reached to 22 consensus proposals on the use of iodine-131 in hyperthyroidism and thyroid cancer, that are reported in this paper. Some of these propositions are: 1) Hyperthyroidism: A previous 131I uptake test must be performed. A calculated or an ablative dose should be administered. Hypothyroidism must be considered an objective rather than a complication. In patients with cardiovascular risk, normal thyroid function must be attained with prophythioturacil. In cases of treatment failure, the dose should not be repeated before six months. It must be used with used with caution in children and teenagers. 2) Thyroid cancer: A iodine free diet is recommended prior to the therapeutic dose. A 100 mCi complementary ablative dose should be given after surgery, with a posterior exploration. This examination must not be done routinely, and if required, a 5 mCi dose should be used. For the treatment of metastases, a dose of 150 to 200 mCi is recommended. There is no radiation risk in hyperthyroidism or thyroid cancer. The only absolute contraindication is pregnancy. Recommendations for radiological protection are formulated. Hospitalization is suggested to protect other people from radiation exposure.

摘要

智利内分泌学会召开的一次共识会议就碘-131在甲状腺功能亢进症和甲状腺癌中的应用达成了22项共识提案,本文对此进行了报道。其中一些提议如下:1)甲状腺功能亢进症:必须先进行一次碘-131摄取试验。应给予计算剂量或消融剂量。甲状腺功能减退应被视为一个目标而非并发症。对于有心血管风险的患者,必须使用丙硫氧嘧啶使甲状腺功能恢复正常。在治疗失败的情况下,六个月内不应重复给药。在儿童和青少年中必须谨慎使用。2)甲状腺癌:在给予治疗剂量之前,建议采用无碘饮食。术后应给予100毫居里的辅助消融剂量,并进行后续探查。此项检查不应常规进行,如有需要,应使用5毫居里的剂量。对于转移灶的治疗,建议使用150至200毫居里的剂量。甲状腺功能亢进症或甲状腺癌不存在辐射风险。唯一的绝对禁忌症是妊娠。制定了放射防护建议。建议住院治疗,以保护其他人免受辐射暴露。

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