RESUMO
Objective:To study the clinical efficacy of surgical resection combined with iodine-131 ( 131I) therapy in elderly patients with differentiated thyroid cancer and its influence on complications. Methods:Totally 82 elderly patients with differentiated thyroid cancer who were admitted to Chengde Central Hospital from March 2019 to March 2021 were selected and divided into observation group (41 cases) and control group (41 cases) according to the random number table. The control group underwent total thyroidectomy + neck lymph node dissection, and the observation group was treated with 131I after the operation on the basis of the control group. The indicators in the two groups were evaluated (postoperative observation time cutoff was 3 months), including perioperative indexes, postoperative complications, Karnofsky (KPS) score, serum levels of lymphocyte activating gene-3 (LAG-3) and recombinant human Dick-kopfx related protein-1 (DKK-1) before and after treatment, and the efficacy. Results:There was no significant difference between the two groups in the amount of intraoperative bleeding and operation time ( P > 0.05); the hospitalization time in the observation group [(6.72 ± 1.39) d] was shorter than that in the control group [(8.78 ± 1.43) d, P < 0.001]. The incidence of complications in the observation group (31.71%, 13/41) was lower than that in the control group (53.66%, 22/41, P = 0.045). After treatment, KPS scores in the two groups were higher than those before treatment ( P < 0.001); after treatment, KPS score in the observation group was higher than that in the control group ( P < 0.001). After treatment, the serum LAG-3 levels in the two groups were higher than those before treatment, while DKK-1 levels were lower than those before treatment ( P < 0.001); after treatment, the serum LAG-3 level in the observation group was higher than that in the control group, while the DKK-1 level was lower than that in the control group ( P < 0.001). The total effective rate of the observation group (95.12%, 39/41) was higher than that of the control group (80.49%, 33/41, P = 0.043). Conclusion:The clinical efficacy of surgical resection combined with 131I therapy in elderly patients with differentiated thyroid cancer is good, and it can reduce postoperative complications, up-regulate the expression of LAG-3 and down-regulate the expression of DKK-1.
RESUMO
Objective To explore the influence of social support on compliance of respiratory function exercise and rehabilitation in patients with coronary artery bypass graft surgery. Methods A total of 102 patients with coronary artery bypass graft surgery were evaluated by General Data Survey Scale,Social Support Questionnaire and Compliance of Respiratory Function Exercise Scale.According to the situation of patients′social support, patients were divided into high score group,medium score group and low score group, then compliance of respiratory function exercise,postoperative ICU stay time, postoperative ventilation time, postoperative hospital stay, 6-min walking test (6MWD) and left ventricular ejection fraction (LVEF) were compared among three groups. Results The social support of patients with coronary artery bypass graft surgery in medium level,the score was (34.70 ±7.46) points. The postoperative ventilation time, postoperative ICU stay time in high score group were less than those in medium score group and low score group:(17.79±5.30) h vs. (42.41±14.18), (80.00±11.15) h, (24.29±6.00) h vs. (55.66±16.31), (92.46±10.21) h, and there were significant differences, F=47.340,110.252,P<0.01. The compliance of respiratory function exercise,6MWD and LVEF in high score group were better than those in medium score group and low score group:(38.93±24.37) points vs.(30.26±4.79), (19.85±4.45) points, (376.07±55.92) m vs. (328.83±59.27), (302.04±60.24) m, (60±4)%vs. (53±9)%, (51±10)%, and there were significant differences, F=286.040, 55.228, 20.159,P < 0.01. Conclusions Social support can improve the patients′adherence to treatment, and enhance the patients′ability to cope with stressful events,then accelerate the process of postoperative rehabilitation of patients effectively,and improve quality of life.