微波消融术治疗甲状腺良性结节的效果观察  

Efficiency observation of microwave ablation in the treatment of patients with benign thyroid nodules

作　　者：易国华 马亚辉 朱洪波[1] YI Guohua;MA Yahui;ZHU Hongbo(Lianyungang Oriental Hospital,Lianyungang,Jiangsu,222042)

机构地区：[1]江苏省连云港市东方医院,江苏连云港222042

出　　处：《实用临床医药杂志》2019年第2期80-82,86,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨微波消融术治疗甲状腺良性结节的临床疗效。方法选取行微波消融术治疗的甲状腺良性结节患者32例(共49个结节)。观察消融效果、术中并发症发生及转归情况。术后1、3、6、12个月随访,观察结节变化及甲状腺功能变化。结果行微波消融术后,49个结节的消融效果均为完全消融。20例患者有颈部受热感和轻微疼痛,但均可耐受。4例患者术后彩超显示结节与气管间出血,压迫颈部15 min后超声观察下出血不再增加。10例患者术后出现声音改变,均在术后3 d内声音恢复如常。未观察到喉返神经损伤、皮肤烫伤、气管损伤、食管损伤、饮水呛咳、血肿形成等并发症。术后随访12个月,所有结节不同程度缩小,与消融前比较差异有统计学意义(P <0. 05)。消融术后1个月复查甲状腺功能,所有患者消融前后甲状腺功能无显著变化(P> 0. 05)。结论微波消融术是一种安全有效的治疗甲状腺良性结节的微创技术,具有手术时间短、颈部不留疤痕、患者痛苦小等优点。Objective To investigate the clinical efficacy of microwave ablation in the treatment of patients with benign thyroid nodules.Methods A total of 32 patients with benign thyroid nodules (49 nodules) treated by microwave ablation were selected.The ablation effect,intra-operative complications and prognosis were observed.The changes of nodules and thyroid function were observed after 1,3,6 and 12 months follow-up.Results After microwave ablation,49 nodules were completely ablated.Twenty patients had tolerable neck fever and mild pain.Four patients had intra-tracheal hemorrhage after operation by color Doppler ultrasonography,and the hemorrhage did not increase after 15 minutes of neck compression.Ten patients had voice changes after operation,and the voice returned to normal within 3 days after operation.No complications such as recurrent laryngeal nerve injury,skin scald,tracheal injury,esophageal injury,cough from drinking water and hematoma formation were observed.After 12 months of follow-up,all nodules reduced significantly in varying degrees (P<0.05).Thyroid function was re-examined one month after ablation,and there was no significant change in thyroid function in all patients before and after ablation (P>0.05).Conclusion Microwave ablation is a safe and effective minimally invasive technique for the treatment of benign thyroid nodules,and it has the advantages of short operation time,no scar on neck and less pain.

关 键 词：微波消融术 甲状腺结节 甲状腺功能 喉返神经 微创手术 

分 类 号：R581[医药卫生—内分泌]