超声引导经皮微波消融甲状腺良性结节的应用研究  

Applied research of ultrasound-guided percutaneous microwave ablation on benign thyroid nodules

作　　者：吴新财[1] 薛玉[1] 陈宝定[1] 张歆[1] 王珂珂[1] 俞力[2] 单秀红[3] 

机构地区：[1]江苏大学附属医院超声科,镇江212001 [2]江苏大学附属医院内分泌科,镇江212001 [3]江苏大学附属人民医院影像科

出　　处：《中国临床保健杂志》2016年第5期495-497,561,562,563,共6页Chinese Journal of Clinical Healthcare

基　　金：江苏省卫计委血地寄防科研课题(X201424)

摘　　要：目的探讨超声引导下经皮穿刺微波消融治疗甲状腺良性结节的临床疗效及并发症等情况.方法选取本院诊治的甲状腺良性结节患者86例（156个结节）,术前细胞学检查确定为良性结节,行超声引导下经皮穿刺结节微波消融术后即刻超声造影,对不全消融结节行二次消融.在术后随访观察消融术后结节大小变化及并发症情况.同时与此期间在我院行甲状腺次全切除术的65例甲状腺良性结节患者作为对照组,分析两组患者的术后并发症出现人数及甲状腺功能恢复等.结果仅4/156枚需二次消融,一次消融率达97.4%.消融后第1、3、6及12个月体积缩小率分别为20.98%,45.37%,75.12%和86.83%;23/156（14.7%）枚结节在随访6-12个月内消失.观察组患者甲状腺功能恢复人数多于对照组,其术后并发症出现人数少于对照组（均P〈0.05）.结论微波消融治疗甲状腺良性结节疗效显著,并发症少,是传统手术治疗的一个有效补充.Objective To explore the clinic effects and complications of ultrasound-guided percutaneous micro-wave ablation（ MWA） on benign thyroid nodules. Methods A total of 156 thyroid nodules in 86 patients were selected from our hospital,and all patients were identified as benign by fine needle aspiration cytology（ FNAC） before receiving ultrasound-guided MWA therapy. The patients received contrast-enhanced ultrasonography （ CEUS） after ultrasound- guided MWA therapy and the second ablation was required if the ablation was not complete, followed by the re-evaluations on the changes of these nodules as well as the complications. Sixty-five patients with benign thyroid nodules which accepted subtotal thyroidectomy treatment were selected as control group. The complications of postoperative and and level of restoring thyroid function of two groups were compared. Results The rate of complete ablation was 97. 4% , only 4 out of 156 nodules needed second ablation. The volume decreased rate of nodules were 20. 9 8 % ,45. 3 7 % ,75. 12% and 86. 3% at 1,3,6,12 months after MWA respectively, and 14. 1% （23/156） nodules were disappeared from 6 to 12 months after ablation. Compared with control group, the population of restoring thyroid function were increasedre markably （ P 〈 0. 05 ） , and the population of postoperative complications was decreased significantly（ P 〈 0. 05 ） in observation group. Conclusion The ultrasound-guided percutaneous MWA is a valuable alternative therapy for the treatment of benign thyroid nodules,with significant effects but less complications. Ultrasound-guided percutaneous MWA is an effective supplement for traditional surgery in the treatment of benign thyroid nodules with low complication and high efficacy.

关 键 词：甲状腺结节 高强聚焦超声消融 超声检查 

分 类 号：R581[医药卫生—内分泌] R445.1[医药卫生—内科学]