超声引导下移动微波消融治疗甲状腺良性结节的临床效果  

Clinical effect of ultrasound-guided moving microwave ablation in the treatment of benign thyroid nodules

作　　者：罗国庆[1] 周晶晶 李关杰 李思文[1] 梁计焕 刘秋华[1] 夏旭[1] 胡宁东[1] LUO Guo-qing;ZHOU Jing-jing;LI Guan-jie;LI Si-wen;LIANG Ji-huan;LIU Qiu-hua;XIA Xu;HU Ning-dong(Department of Cardiothoracic Surgery,the Sixth Affiliated Hospital of Guangzhou Medical University People′s Hospital of Qingyuan City,Guangdong Province,Qingyuan 511500,China)

机构地区：[1]广州医科大学附属第六医院广东省清远市人民医院胸心外科,广东清远511500

出　　处：《中国当代医药》2019年第11期12-15,共4页China Modern Medicine

基　　金：广东省清远市科技计划项目(2016B008)

摘　　要：目的观察超声引导下移动微波消融技术在甲状腺良性结节中的临床效果。方法选取我院2016年7月～2017年8月收治的143例甲状腺结节患者作为研究对象,按照治疗方法的不同分为微波消融组(50例)及传统开放手术组(93例)。微波消融组采用超声引导下移动微波消融技术,传统开放手术组使用甲状腺次全切除术进行治疗,对比两组的手术时长、出血量、住院时间、住院费用、并发症发生情况及手术前后促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_3)、游离四碘甲状腺原氨酸(FT_4)水平。消融后分别于1、3、6、12个月随访结节的体积,并在术后1个月复查甲状腺功能。结果微波消融组的手术时间、住院时间短于传统手术组,出血量少于传统手术组,住院费用高于传统开放手术组,差异均有统计学意义(P<0.01)。两组均未发生声音嘶哑、甲状旁腺损伤等并发症;微波消融组的并发症总发生率低于传统开放手术组,差异有统计学意义(P<0.05)。两组患者术前的TSH、FT3、FT4水平比较,差异无统计学意义(P>0.05)。两组患者术后1个月的FT_3、TSH水平比较,差异无统计学意义(P>0.05)。微波消融组术后的FT_4水平高于术前,低于传统开放手术组,差异均有统计学意义(P<0.05)。微波消融术后1个月的包块体积与术前比较,差异无统计学意义(P>0.05);自术后3个月开始,包块体积缩小明显,差异有统计学意义(P<0.05)。结论超声引导下移动微波消融技术治疗甲状腺良性结节的手术时间短,术中出血少,住院时间短,并发症发生率低,手术效果良好,为本地区微创治疗甲状腺疾病提供了新的选择与途径。Objective To observe the clinical effect of ultrasound-guided moving microwave ablation in the treatment of benign thyroid nodules.Methods A total of 143 patients with thyroid nodules from July 2016 to August 2017 treated in our hospital were selected as research objects,and they were divided into the microwave ablation group(50 cases)and the traditional open surgery group(93 cases)according to different treatment methods.Ultrasound-guided moving microwave ablation was used in the microwave ablation group,while subtotal thyroidectomy was used in the traditional open surgery group.The operation time,bleeding volume,hospitalization time,hospitalization expenses,complications and the levels of thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free tetraiodothyronine(FT4)before and after surgery were compared between the two groups.The volume of nodules was followed up at 1,3,6 and 12 months after ablation,and thyroid function was reexamined one month after ablation.Results The operation time and hospitalization time of the microwave ablation group were shorter than those of the traditional open surgery group,the amount of bleeding of the microwave ablation group was less than that of the traditional open surgery group,and the hospitalization cost of the microwave ablation group was higher than that of traditional open surgery group,with statistically significant differences(P<0.01).There were no complications such as hoarseness and parathyroid injury in both groups.The total incidence rate of complications in the microwave ablation group was lower than that in the traditional open surgery group,and the difference was statistically significant(P<0.05).There were no significant difference in the levels of TSH,FT3 and FT4 between the two groups before operation(P>0.05).There were no significant differences in the levels of FT3 and TSH between the two groups one month after operation(P>0.05).The level of FT4 in the microwave ablation group was higher than that before operation,and which was lower than that in

关 键 词：超声引导 微波消融 甲状腺 结节 

分 类 号：R736.1[医药卫生—肿瘤]