目的 探讨专科规范化随访手册治疗在甲状腺微小乳头状癌（papillary thyroid microcarcinoma, PTMC）术后病人中的实施效果。方法 200例PTMC术后病人随机分为研究组（100 例）和对照组（100 例）,两组住院期间均予专科健康教育。研究组出院后给予专科规范化随访治疗,建立并使用甲状腺术后病人随访手册。两组均确定促甲状腺激素（thyroid stimulating hormone,TSH）抑制治疗至0.1 mU/L,细化专科随访内容包括饮食、药物、运动。收集两组术后3个月相关资料,比较两组病人TSH指标及颈部超声检查复发率、门诊规律性随访率、低碘饮食依从率、优甲乐（L-T4）用药依从率、颈肩部锻炼依从率。结果 术后3个月超声检查未见复发。研究组TSH显著低于对照组（P<0.05）,门诊规律性随访率、低碘饮食依从率、优甲乐用药依从率、颈肩部锻炼依从率两组比较差异有统计学意义（P<0.05）。结论 采用专科随访手册的规范化随访,在病人术后应用有助于提高治疗依从性,改善TSH抑制治疗效果。
Objective To investigate the effect of specialized standardized follow-up manual for postoperative patients with papillillary thyroid microcarcinoma (PTMC). Methods A total of 200 PTMC patients were randomly divided into study group and control group each 100 cases. Both groups received specialized health education during hospitalization. The patients in study group got specialized follow-up after discharge using the standardized manual of follow-up. Thyroid stimulating hormone (TSH) should be suppressed to 0.1 mU/L for patients with PTMC in both groups postoperatively. Contents of detailed specialized follow-up included diet, medical treatment and exercise. Outcome of follow-up was compared between 2 groups for TSH detection and neck ultrasound examination. Compliance rate was involved low-iodine diet, Euthyrox medication and exercise. Results No recurrent PTMC was found 3 months later postoperatively with ultrasound examination for both groups. Values of TSH in study group were significantly lower than those in control group after 1 month of operation (P< 0.05). There was statistical significant difference in regular follow-up rate, adherent rate of low iodine diet, Euthyrox medication and exercise between 2 groups (P< 0.05). Conclusions The application of specialized follow-up manual in postoperative patients is helpful to improve compliance for treatment and the effect of TSH inhibition.
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