超声引导下经皮穿刺注射无水乙醇治疗甲状腺良性病变  

Sonographically guided percutaneous ethanol injection for therapy of thyroid benign lesion

作　　者：牛丽娟[1] 李洪林[1] 李正江[2] 唐平章[2] 

机构地区：[1]中国医学科学院肿瘤医院影像诊断科,北京100021 [2]中国医学科学院肿瘤医院头颈外科,北京100021

出　　处：《中华耳鼻咽喉头颈外科杂志》2008年第6期428-431,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的开展甲状腺良性病变的微创治疗，评价超声引导下经皮穿刺注射无水乙醇治疗甲状腺良性病变的有效性。方法总结分析2002年6月至2006年3月32例甲状腺良性病变患者接受超声引导下经皮乙醇注射治疗。病例选择标准：囊性或囊实性结节、实性病变最大直径不超过3cm、无严重的心肺疾病和酒精过敏史。32例患者分为两组，第一组14例（2002年6月至2003年8月），第二组18例（2003年9月至2006年3月）。第一组注射无水乙醇次数平均4次（1—6）次，每次注射乙醇量的原则是，对于实性区域病变乙醇要在病灶内均匀分布，并保持轻微注射压力约5min；对于囊性病变首先吸出部分囊液，然后囊内注射乙醇2—10ml，每周穿刺注射1次。第二组每例穿刺注射6次，注射方法与第一组相同。随诊12—57个月，平均随诊29个月。结果第一组治疗有效率为100．0％，治愈率为69．2％；第二组治疗有效率为100．0％，治愈率为77．8％。经统计学分析，两组治愈率差异无统计学意义（x^2=0．0258，P〉0．05）。在随诊期间，超声显示治愈患者无复发，残留的肿瘤无增大。其并发症是暂时的，无严重并发症出现。结论超声引导下经皮穿刺注射无水酒精治疗甲状腺良性占位性病变应该是安全、有效的，方法简单，易于普及。Objective To develop the microtrauma therapy for thyroid benign lesion, to evaluate efficacy of sonographically guided percutaneous ethanol injection for therapy of thyroid benign lesion. Methods Thirty-two patients with thyroid benign lesion were treated in Cancer Hospital, the patients had thyroid disease with cystic or cystic and solid nodule without heart and lung disease, and no allergy to ethanol, but the most diameter was below 3 cm for the solid disease. These patients were divided into two groups, the first group were 14 patients（from June 2002 to August 2003） ,the second group was 18 patients （from September 2003 to March 2006）. The mean injection times was four （1 -6） in the first group,the volume of each ethanol injection made the absolute ethanol well-distributed and kept slight compression intralesion for five minutes for solid disease. Partial liquid was extracted for cystic disease first, and 2 - 10 ml ethanol was injected into cyst, the internal time between two punctures was one week. Each patient received six times ethanol injection in the second group, ethanol injection was same with the first group. The mean follow-up was29 （12-57） months. Results The efficacy rate was 100.0%, the cure rate was 69.2% in the first group. The efficacy rate was 100. 0% , the cure rate was 77. 8% in the second group. There was no significant difference in the cure rate between the groups （ x^2 = 0. 0258, P 〉 0. 05 ）. During follow-up, ultrasound revealed no recurrence for the cured patients and no growth for the remnant lesion. Its complications were transient after the procedure, no severe complications occurred. Conclusions Sonographically guided percutaneous ethanol injection should be simple, effective, and safe for the thyroid benign lesion, it is easy popularized and may has the effect of cosmetology＇ and microtrauma.

关 键 词：甲状腺肿瘤 超声检查 乙醇 

分 类 号：R686[医药卫生—骨科学]