液体隔离带法联合杠杆撬离法微波消融高风险甲状腺结节  

Hydrodissection combined with leverage displacement in microwave ablation of high-risk thyroid nodules

作　　者：韩彬[1] 刘玉婷 HAN Bin;LIU Yuting(Department of Ultrasound,the Hospital of Shanxi University of TCM, Clinical TCMCollege of Shanxi University of TCM,Taiyuan 030024,China;Department ofNeurology,Shanxi Cardiovascular Disease Hospital,Taiyuan 030024,China)

机构地区：[1]山西中医学院中医临床学院山西中医学院附属医院超声科,山西太原030024 [2]山西省心血管病医院神经内科,山西太原030024

出　　处：《中国医学影像技术》2019年第4期526-529,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察液体隔离带法联合杠杆撬离法对于微波消融高风险甲状腺结节中避免喉返神经(RLN)损伤的价值。方法对172例患者共201个高风险甲状腺结节行超声引导下微波消融治疗,40例采用液体隔离带法、52例采用杠杆撬离法、80例采用液体隔离带法联合杠杆撬离法,以预防热损伤RLN,比较3种方法RLN损伤的发生率。结果 201个高风险甲状腺结节均完全消融。4例发生RLN损伤,发生率为2.33%(4/172),其中3例(3/40,7.50%)采用液体隔离带法,1例(1/52,1.92%)采用杠杆撬离法。采用液体隔离带法联合杠杆撬离法患者均未发生RLN损伤。3种方法的RLN损伤率总体差异有统计学意义(P=0.021),两两比较差异均有统计学意义(P均<0.017)。结论液体隔离带法联合杠杆撬离法微波消融高风险甲状腺结节可有效避免RLN损伤,值得临床推广。Objective To explore the application value of hydrodissection combined with leverage displacement method in microwave ablation of high-risk thyroid nodules to prevent recurrent laryngeal nerve (RLN) injury. Methods A total of 201 high-risk thyroid nodules in 172 patients were treated with ultrasound-guided microwave ablation,40 were treated with hydrodissection,52 with leverage displacement,and 80 with hydrodissection combined with leverage displacement method to prevent thermal injury of RLN.The incidences of RLN injury were compared among the 3 methods. Results All 201 high-risk thyroid nodules were completely ablated.RLN injury was found in 4 patients (4/172,2.33%),including 3 patients (3/40,7.50%) under hydrodissection and 1 (1/52,1.92%) under leverage displacement.No RLN injury occurred in patients under hydrodissection combined with leverage displacement method.The incidences of RLN injury were different among 3 methods ( P =0.021),also between each 2 methods (all P <0.017). Conclusion Hydrodissection combined with leverage displacement during microwave ablation for high-risk thyroid nodules can effectively reduce the risk of RLN injury,worthy of clinical promotion.

关 键 词：甲状腺结节 微波消融 超声检查 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]