甲状腺结节性疾病超声诊疗的研究进展  

Research Progress in Ultrasonic Diagnosis and Treatment of Thyroid Nodular Disease

作　　者：何晓娜 张小鹏 王斌儒 刘海鹏 陈晓[2,3] HE Xiaona;ZHANG Xiaopeng;WANG Binru;LIU Haipeng;CHEN Xiao(The Second Clinical Medical College of Lanzhou University,Lanzhou 730030,China;Key Laboratory of Digestive System Tumors of Gansu Province,Lanzhou 730030,China;Dep artment Three of General Surgery,Lanzhou University Second Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学第二临床医学院,兰州730030 [2]甘肃省消化系肿瘤重点实验室,兰州730030 [3]兰州大学第二医院普外三科,兰州730030

出　　处：《医学综述》2018年第12期2467-2475,共9页Medical Recapitulate

摘　　要：甲状腺结节性疾病首选影像学检查是超声。随着超声技术的不断发展,传统超声技术、超声新技术及超声引导下细针穿刺活检得到了飞速发展。这些诊断技术在临床应用中体现了各自的优越性及不足。虽然手术是甲状腺结节的主流治疗方法,治疗彻底,但创伤大、影响美观,因此超声引导下经皮微创性治疗应运而生,如经皮乙醇注射、射频消融、激光消融和微波消融。经皮乙醇注射更适合治疗囊性或以囊性为主的良性甲状腺结节。射频消融是唯一一种被越来越多用于复发性甲状腺癌的微创方法。激光消融治疗区域可预测,相对比较精准,降低了对周围结构的损伤和不良反应的风险。微波消融消融区域更大、消融时间更快、患者痛苦相对小。The preferred imaging examination for thyroid nodular diseases is ultrasound. With the continuous development of ultrasound technology,traditional ultrasound techniques,new ultrasound technologies and ultrasound-guided fineneedle aspiration biopsy have developed rapidly. These diagnostic techniques reflect their respective advantages and disadvantages in the clinical applications. Although surgery is the main treatment for thyroid nodules with thorough effect but is also traumatic and aesthetically displeasing,ultrasound-guided percutaneous minimally invasive treatment is therefore required,such as percutaneous ethanol injection,radiofrequency ablation,laser ablation,and microwave ablation. Percutaneous ethanol injection is more suitable for the treatment of cystic benign thyroid nodules. Radiofrequency ablation is the only minimally invasive method used more and more for recurrent thyroid cancer. The treatment areas of laser ablation are predictable and relatively accurate,reducing the risk of damage and adverse reactions to the surrounding structures. The area of microwave ablation is larger,the ablation time is shorter,and the patient＇s pain is relatively small.

关 键 词：甲状腺结节性疾病 超声 诊断 治疗 

分 类 号：R604[医药卫生—外科学] R605[医药卫生—临床医学]