微波消融术与传统开放手术治疗甲状旁腺瘤的临床效果比较  

Comparison of Clinical Effects between Microwave Ablation and Traditional Open Surgery for Parathyroid Adenoma

作　　者：黎夏 黄俏平 谢家耀 陈振寰 LI Xia;HUANG Qiaoping;XIE Jiayao;CHEN Zhenhuan(Yangjiang Hospital of Traditional Chinese Medicine,Yangjiang 529500,China)

机构地区：[1]广东省阳江市中医医院,广东阳江529500 [2]广东省阳江市人民医院

出　　处：《中国医学创新》2020年第20期23-27,共5页Medical Innovation of China

摘　　要：目的:对比分析微波消融术与传统开放手术治疗甲状旁腺瘤的临床效果.方法:回顾性分析2015年10月-2017年9月阳江市中医医院收治的108例甲状旁腺瘤患者的临床资料,根据手术治疗方式不同将其分为对照组52例和观察组56例.对照组患者采用传统开放手术治疗,观察组患者采用超声引导下微波消融术治疗.比较两组患者的手术情况、甲状腺旁腺素(PTH)、血清钙、磷水平变化情况、应激反应及术后并发症发生情况.结果:观察组患者手术时间和住院时间均短于对照组,术中出血量明显少于对照组(P<0.05).术后1、3、6个月,两组患者PTH、血钙及血磷水平较术前均明显下降(P<0.05).术后12 h,两组的肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平均较术前升高(P<0.05),且观察组的TNF-α、IL-6、CRP水平均明显低于对照组(P<0.05).两组患者术后并发症发生率比较,差异无统计学意义(P>0.05).结论:微波消融术治疗甲状旁腺瘤可达到与传统开放手术相同的效果,且患者手术时间、住院时间更短,术中出血量更少,创伤更小,值得在临床上推广应用.Objective:To compare and analyze the clinical effect of microwave ablation and traditional open surgery in the treatment of parathyroid adenoma.Method:The clinical data of 108 patients with parathyroid adenoma admitted to Yangjiang Hospital of Traditional Chinese Medicine from October 2015 to September 2017 were retrospectively analyzed,they were divided into 52 cases in the control group and 56 cases in the observation group by different surgical treatment methods.Patients in the control group were treated with conventional open surgery,and patients in the observation group were treated with ultrasound-guided microwave ablation.The operation status,parathyroid hormone(PTH),serum calcium and phosphorus levels,stress response and postoperative complications were compared between the two groups.Result:The operative time and hospital stay of patients in the observation group were shorter than those in the control group,and the intraoperative blood loss was significantly less than that in the control group(P<0.05).At 1,3,and 6 months after surgery,PTH,serum calcium,and serum phosphorus levels in both groups were significantly lower than those before surgery(P<0.05).At 12 h postoperatively,tumor necrosis factorα(TNF-α),interleukin-6(IL-6),and C-reactive protein(CRP)levels in both groups were higher than those before surgery(P<0.05),the levels of TNF-α,IL-6 and CRP in the observation group were significantly lower than those in the control group(P<0.05).Comparison of postoperative complications between the two groups showed no statistically significant difference(P>0.05).Conclusion:Microwave ablation of parathyroid adenoma can achieve the same effect as conventional open surgery,and patients have shorter operative time,shorter hospitalization time,less intraoperative blood loss,and less trauma,it is worthy of being popularized and applied in clinical practice.

关 键 词：甲状旁腺瘤 微波消融术 开放手术 甲状腺功能 应激 

分 类 号：R736.2[医药卫生—肿瘤]