超声引导经皮射频消融治疗甲状腺良性肿瘤疗效分析  

Treatment efficiency of thyroid benign nodules by ultrasound-guided radiofrequency ablation

作　　者：杜军威[1] 付利军[1] 焦赞 李洪婷[1] 李国权 尚朝阳 孔玉静 邱新光[1] Du Junwei;Fu Lijun;Jiao Zan;Li Hongting;Li Guoquan;Shang Zhaoyang;Kong Yujing;Qiu Xinguang(Department of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University,International Joint Laboratory of Thyroid Thermal Ablation in Henan Province,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院甲状腺外科,河南省甲状腺结节热消融国际联合实验室,450052

出　　处：《国际外科学杂志》2019年第12期814-818,共5页International Journal of Surgery

基　　金：河南省高等学校重点科研项目(18A320008)。

摘　　要：目的分析超声引经皮射频消融技术(RFA)治疗甲状腺良性肿瘤的有效性和安全性。方法回顾性分析2014年6月-2017年9月郑州大学第一附属医院甲状腺外二科收治的573例RFA治疗的甲状腺良性肿瘤患者临床资料,其中男性75例,女性498例;年龄在6~82岁,中位年龄为45岁。术前均行彩超和超声引导下细针穿刺抽吸活检,病理结果确定为良性肿瘤行RFA,一共消融750个良性肿瘤。所有患者均行RFA治疗。评估患者术前及术后3个月甲状腺功能,并于术后3、6、12个月行彩超检查观察其变化,符合正态分布的计量资料组间比较采用配对t检验;非正态分布的计量资料组间比较采用Wilcoxon符号秩检验。计算甲状腺良性肿瘤体积改变及缩小率。结果所有病例均顺利完成RFA,术后随访1年,术后3个月体积缩小率为67%(48%,83%),术后6个月体积缩小率为81%(67%,91%),术后1年体积缩小率为89%(80%,95%)。术中18例出现颈部疼痛,停止消融后缓解;3例声音降低,1周左右后恢复;6例声音嘶哑,3个月左右恢复;3例出现颈部出血,颈部压迫后好转。结论RFA治疗甲状腺良性肿瘤是安全有效的,具有创伤小、不影响甲状腺功能的特点,值得推广应用。Objective To explore the effectiveness and safety of ultrasound-guided radiofrequency ablation(RFA)in treatment of thyroid benign nodules.Methods We analyze 573 patients with thyroid benign nodules from June 2014 to September 2017 treated by RFA at DepartmentⅡof Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University.Among these patients,there were 75 males and 498 females,with a median age of 45 years old.All patients were diagnosed as thyroid benign nodules by ultrasound-guided fine needle aspiration biopsy before RFA.A total of 750 benign tumors were treated.To evaluate the thyroid function of the patients before RFA and 3 months after it,and to observe the changes of thyroid benign nodules by ultrasound at 3,6,12 months after RFA.The paired t-test was used to compare the measurement data with normal distribution,and Wilcoxon's signed rank test was used to compare the measurement data with non-normal distribution.To calculate the volume change and reduction rate of thyroid benign nodules.Results RFA was successfully completed in all patients,the volume reduction rate was 67%(48%,83%)in the 3rd month after RFA,in the 6th month was 81%(67%,91%),in the 12th month was 89%(80%,95%).Eighteen patients felt pain during RFA,but the pain was alleviated after stopping ablation.Three patients′tone decreased,but recovered in a week.Hoarseness occurred in 6 patients and recovered in 3 months.Three patients had neck hemorrhage,which was managed with simple compression of the neck.Conclusions RFA is an effective and safe treatment for thyroid benign nodules and has obvious advantages such as less invasiveness,having no influence in thyroid functions.It is clinically prospective for application.

关 键 词：回顾性研究 甲状腺肿瘤 活组织检查 针吸 射频消融 超声引导 

分 类 号：R73[医药卫生—肿瘤]