经皮微波消融治疗甲状腺良性结节的临床疗效研究  

Study on the Clinical efficacy of Percutaneous Microwave Coagulation Therapy in the Treatment of Benign Thyroid Nodules

作　　者：陈吉东[1] 岳林先[1] 熊晏群[2] 顾毅[3] 陈琴[1] 吴昊[1] Chen Jidong;Yue Linxian;Xiong Yanqun;Gu Yi;Chen Qin;Wu Hao(Department of Ultrasonic Medicine, Sichuan Provincial People′s Hospital, Chengdu 610072, China;Operating Room, Sichuan Provincial People′s Hospital, Chengdu 610072, China;Department of Vascular Thyroid Surgery, Sichuan Provincial People′s Hospital, Chengdu 610072, China)

机构地区：[1]四川省人民医院超声医学科,成都610072 [2]四川省人民医院手术室,成都610072 [3]四川省人民医院血管甲状腺外科,成都610072

出　　处：《成都医学院学报》2019年第5期616-620,共5页Journal of Chengdu Medical College

摘　　要：目的对比分析增强超声(CEUS)与彩色多普勒超声(CDFI)引导下经皮微波消融治疗(PMCT)甲状腺良性结节的临床疗效和并发症。方法236例甲状腺良性结节患者,随机分成CEUS组和CDFI组。CEUS组137例,共153枚结节,经常规超声(US)和CEUS引导下行PMCT。CDFI组99例,共112枚结节,经US和CDFI引导下同样条件行PMCT。结果3个月后,CEUS组完全消融率高于CDFI组,差异有统计学意义(P<0.05)。24个月后,CEUS组完全消融率高于CDFI组,复发率低于CDFI组,差异均有统计学意义(P<0.05)。消融后3、12及24个月,CEUS组结节体积缩小率均高于CDFI组,差异均有统计学意义(P<0.05)。CEUS组并发症发生率低于CDFI组(P<0.05),但对甲状腺功能和症状及美容评分的差异无统计学意义(P>0.05)。结论两种方法均能有效完成消融治疗,但CEUS引导下PMCT更能有效提高完全消融率和减少并发症。Objective To compare the clinical efficacy and complications of the percutaneous microwave coagulation therapy (PMCT) guided by contrast enhanced ultrasound (CEUS) or color Doppler flowing imaging (CDFI) in the treatment of benign thyroid nodules. Methods A total of 236 patients with benign thyroid nodules were randomly divided into the CEUS group and CDFI group. In the CEUS group, there were 137 cases with 153 nodules, and PMCT was guided by conventional ultrasound (US) and CEUS. In the CDFI group, there were 99 cases with 112 nodules and PMCT was guided by US and CDFI with the same conditions. Results The complete ablation rate in the CEUS group was significantly higher than that in the CDFI group ( P =0.012) after 3 months. The complete ablation rate in the CEUS group was higher than that in the CDFI group and the recurrence rate in the CEUS group was lower than that in the CDFI group after 12 months, the differences were statistically significant ( P <0.05). The nodule volume reduction rate in the CEUS group was significantly higher than that in the CDFI group at the 3rd, 6th and 12th month after ablation respectively ( P < 0.05), and the incidence of complications in the CEUS group was significantly lower than that in the CDFI group ( P = 0.029). There were no significant differences in the thyroid function, symptoms and cosmetic scoring between the two groups ( P >0.05). Conclusion CEUS-guided and CEUS-guided PMCT can effectively complete the ablation, but CEUS-guided PMCT is more effective in improving the complete ablation rate and reducing complications.

关 键 词：增强超声 彩色多普勒超声 甲状腺良性结节 经皮微波消融术 

分 类 号：R58[医药卫生—内分泌]