超声引导下经皮激光消融治疗甲状腺乳头状癌术后复发转移淋巴结  

Ultrasound-guided percutaneous laser ablation for treatment of post-operative cervical metastatic lymph nodes of recurrent papillary thyroid carcinoma

作　　者：张璐[1] 詹维伟[1] 周伟[1] 彭艳[1] 徐上妍[1] ZHANG Lu;ZHAN Weiwei;ZHOU Wei;PENG Yan;XU Shangyan(Department of Ultrasound,Ruijin Hospital,Shanghai Jiao Tong UniversitySchool of Medicine,Shanghai 200025,Chin)

机构地区：[1]上海交通大学医学院附属瑞金医院超声医学科,上海200025

出　　处：《中国介入影像与治疗学》2018年第8期461-464,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：上海申康医院发展中心临床辅助科室(超声医学)能力建设项目(SHDC22015006)

摘　　要：目的评价超声引导下经皮激光消融(PLA)治疗复发性甲状腺乳头状癌颈部转移淋巴结的安全性及有效性。方法对23例甲状腺乳头状癌术后复发颈部淋巴转移患者共30枚转移淋巴结行超声引导下PLA治疗,观察并记录并发症情况,术后进行随访。对比治疗前淋巴结最大径及体积与治疗后消融区最大径及体积的差异,并比较治疗前后患者甲状腺球蛋白(Tg)的差异。结果 30枚淋巴结均经1次治疗完全消融。术后随访(32.22±6.26)个月,末次随访复查时消融区最大径及体积明显小于治疗前淋巴结最大径[(0.62±1.42)mm vs(7.39±2.63)mm;t=12.960,P<0.001]及体积[122.14(48.52,227.10)mm^3 vs 0(0,0)mm^3;Z=4.587,P<0.001]。术后仅1例发生喉返神经损伤,于3个月内自行恢复;其余患者均无颈部血肿、局部感染或气管及食管损伤等严重并发症。结论超声引导下PLA是一种安全、有效的治疗复发性甲状腺乳头状癌颈部转移淋巴结的方法。Objective To evaluate the safety and efficacy of ultrasound-guided percutaneous laser ablation（PLA）for treating cervical metastatic lymph nodes of recurrent papillary thyroid carcinoma（PTC）.Methods Ultrasound-guided PLA was performed on 23 post-surgery patients with 30 cervical metastatic lymph nodes of PTC recurrence.The complications were recorded after PLA,and long-term follow-up observations were achieved.The diameter and volume of metastatic lymph nodes before PLA were measured and compared with those of ablation area after treatment.The difference of serum thyroglobulin（Tg）before and after PLA was analyzed.Results All of 30 metastatic lymph nodes were successfully treated for one time of PLA.The last ultrasonography during follow-up（mean [32.22±6.26]months）showed the diameter（[0.62±1.42]mm vs [7.39±2.63]mm;t=12.960,P0.001）and volume（122.14 [48.52,227.10]mm^3 vs 0 [0,0]mm^3;Z=4.587,P0.001）of ablation area were significantly smaller than those of metastatic lymph nodes before PLA.One patient occurred recurrent nerve injury after PLA and recovered in 3 months without clinical intervention.No severe complication occurred in the other patients.Conclusion Ultrasound-guided PLA is a minimally invasive and effective method for treating cervical metastatic lymph nodes of recurrent papillary thyroid carcinoma.

关 键 词：经皮激光消融 甲状腺肿瘤 淋巴转移 

分 类 号：R736.1[医药卫生—肿瘤] R815[医药卫生—临床医学]