无水乙醇与聚桂醇注射液超声引导下硬化治疗甲状腺囊性病变疗效比较  

Comparative study of the therapeutic effect between absolute alcohol and Lauromacrogol injection in ultrasound-guided treatment of thyroid cystic lesion

作　　者：陈吉东[1] 岳林先[1] 冯超[2] 熊晏群[3] 陈琴[1] 罗俊[1] 吴昊[1] 

机构地区：[1]四川省医学科学院.四川省人民医院超声科,成都610072 [2]四川省医学科学院.四川省人民医院甲状腺外科,成都610072 [3]四川省医学科学院.四川省人民医院手术室,成都610072

出　　处：《中华医学超声杂志（电子版）》2015年第9期734-738,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的对比分析无水乙醇与聚桂醇注射液超声引导下硬化治疗甲状腺囊性病变的疗效与安全性。方法 2008年2月至2010年2月四川省人民医院收治的超声诊断为甲状腺囊性病变患者83例,共86个病灶,采用无水乙醇超声引导下硬化治疗;2010年6月至2014年1月四川省人民医院收治的超声诊断为甲状腺囊性病变患者102例,共119个病灶,采用聚桂醇注射液超声引导下硬化治疗。采用非参数秩和检验比较2组患者疗效差异;采用χ2检验、Fisher确切概率法比较2组患者并发症发生率差异。结果 2组患者所有病灶均在超声引导下一次穿刺成功。2组患者均随访12个月以上,无水乙醇治疗组患者治愈率为91.9%(79/86),聚桂醇注射液治疗组患者治愈率为89.1%(106/119),2组患者疗效差异无统计学意义(Z=-0.458,P=0.647)。无水乙醇治疗组患者患侧颈部不适发生率为32.5%(27/83),针道出血发生率为9.6%(8/83),醉酒样反应发生率为8.4%(7/83),均高于聚桂醇注射液治疗组患者的15.7%(16/102)、2.0%(2/102)、0(0/83),且差异均有统计学意义[χ2=32.751,P<0.05;P=0.045、0.003(Fisher确切概率法)];无水乙醇治疗组患者囊内出血发生率为4.8%(4/83),低于聚桂醇注射液治疗组患者的8.8%(9/102),但差异无统计学意义。结论聚桂醇注射液治疗甲状腺囊性病变的疗效与无水乙醇相同,但不良反应明显少于后者,是一种更安全有效的硬化剂。Objective To investigate the efficiency and safety of absolute alcohol injection and lauromacrogol injection in ultrasound-guided sclerotherapy of thyroid cystic lesion. Methods There were 86 lesions in 83 patients of thyroid cystic lesion in absolute alcohol treatment group from February 2008 to February 2010. And there were 119 lesions in 102 patients of thyroid cystic lesion in lauromacrogol injection treatment group from June 2010 to January 2014. All cases were treated by pereutaneous ultrasound-guided injection. Therapeutic effect and side effect were observed and the baseline data of all the patients were analyzed. Results All patients were followed up for 12 months or more, the cure rate was 91.9% （79/86） in absolute alcohol treatment group, while it was 89.1% （106/119） in lauromacrogol injection treatment group. There was no statistically significant difference between the two groups （Z=-0.886, P=0.376）. The occurrence rate of neck discomfort in absolute alcohol treatment group was 32.5% （27/83）, and it was 15.7% （16/102） in lauromacrogol injection treatment group. The difference was statistically significant （χ2=32.751, P 〈 0.05）. The occurrence rate of puncture-related needle-tract hemorrhage in absolute alcohol treatment group was 9.6% （8/83）, and it was 2.0% （2/102） in lauromacrogol injection treatment group. The difference was statistically significant （P=0.045）. The occurrence rate of intracystic hemorrhage in absolute alcohol treatment group was 4.8% （4/83）, and it was 8.8% （9/102） in lauromacrogol injection treatment group. The difference was not statistically significant. Conclusions The therapeutic effect of lauromacrogol injection and absolute alcohol injection in treatment for thyroid cystic lesion is similar, but the side effect is significantly less than the latter one. So lauromacrogol injection is safer than the absolute alcohol injection.

关 键 词：无水乙醇 聚桂醇注射液 超声检查 介入性 硬化疗法 甲状腺疾病 

分 类 号：R581[医药卫生—内分泌] R445.1[医药卫生—内科学]