超声引导下射频消融联合乙醇消融与单纯射频消融治疗甲状腺良性囊实性结节的疗效对比  

Comparison of efficacy of ultrasound-guided radiofrequency ablation combined with ethanol ablation versus radiofrequency ablation for benign cystic solid thyroid nodules

作　　者：徐鹏飞 邱新光[1] 郑守华[1] 崔可飞[1] 薛文萍 邓真 李建华[1] Xu Pengfei;Qiu Xinguang;Zheng Shouhua;Cui Kefei;Xue Wenping;Deng Zhen;Li Jianhua(Department of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou450052,China)

机构地区：[1]郑州大学第一附属医院甲状腺外科,450052

出　　处：《国际外科学杂志》2021年第2期114-119,共6页International Journal of Surgery

基　　金：河南省医学科技攻关省部共建青年项目(SB201902003);河南省自然科学基金面上项目(202300410451);河南省卫生计划生育委员会科技攻关项目(201702067)。

摘　　要：目的探讨射频消融联合乙醇消融与单纯射频消融对良性囊实性甲状腺结节治疗效果的差异。方法选取2015年1月-2018年7月就诊于郑州大学第一附属医院甲状腺外科,颈部彩超确认为甲状腺囊实性结节,且结节最大直径≥20 mm,穿刺病理结果为良性,拟行甲状腺射频消融手术的80例患者的病理资料,根据病情及患者意愿,分别行单纯射频消融手术治疗(A组,n=40)和射频消融联合乙醇消融治疗(B组n=40),观察术中射频消融能量差异、术后并发症情况、术后12个月患者满意度和术后3、6、12个月结节体积及最大直径的变化。分析两组各自的临床效果及两组之间的疗效差异,符合正态分布的计量资料组间比较采用两因素重复测量方差分析或独立样本r检验的统计学方法。不符合正态分布的计量资料组内比较采用Friedman的秩和检验,两两比较采用Bonferroni校正。计数资料组间比较采用x^(2)检验。结果B组术后12个月结节体积较术前缩小值大于A组,差异有统计学意义[(7.0±5.1)mL比(5.5±4.9)mL,P<0.05];B组术后12个月结节最大直径较术前缩小值大于A组,差异有统计学意义[(1.5±0.6)cm比(1.4±0.8)cm,P<0.05];术后6-12个月期间.B组结节缩小趋势较A组更明显(P<0.05)。B组射频能量小于A组,差异有统计学意义[(2.37+1.18)kJ比(3.89±1.17)kJ,P<0.05]。术后2例出现声音降低,2周内恢复;术中1例出现局部出血,消融后止血。A组患者满意度,与B组患者满意度相比,差异无统计学意义(87.5%比90.0%,P>0.05)。结论甲状腺良性囊实性结节行射频消融联合乙醇消融治疗,较单纯射频消融治疗可以取得更好的结节缩小效果,且能够降低消融使用能量。Objective To investigate the difference of radiofrequency ablation combined with ethanol ablation and radiofrequency ablation in the treatment of benign cystic solid thyroid nodule.Methods A total of 80 patients who visited the Thyroid Surgery Department of the First Affiliated Hospital of Zhengzhou University from January 2015 to July 2018 were selected.All selected patients are required to meet the following criteria:(1)Color doppler ultrasonography of the neck revealed a cystic solid thyroid nodule greater than 20 mm in diameter.(2)The results of fine needle aspiration cytology of thyroid nodules were benign.(3)The patients is to undergo radiofrequency ablation of thyroid nodule.According to the condition and patientsz wishes,radiofrequency ablation(Group A,n=40)and combined ethanol and radiofrequency ablation(Group B,n=40)were performed respectively to observe the changes of nodule volume and maximum diameter at 3,6 and 12 months after surgery.The difference of intraoperative radiofrequency ablation energy,postoperative complications and patient satisfaction at 12 months after operation were also observed.The respective clinical effects of the two groups and the difference of curative effects between the two groups were analyzed.Two-factor repeated measurement analysis of variance or independent sample t test was used to compare the measurement data in line with normal distribution between groups.Friedman's rank sum test was used for comparison of measurement data groups that did not conform to normal distribution,and Bonferroni correction was used for pairwise comparison.Chi-square test was used to compare the counting data between groups.Results On the 12th months after operation,the volume reduction of of nodules in group B was greater than that of group A,and the difference was statistically significant[(7.0±5.1)mL vs(5.5±4.9)mL,P<0.05].The maximum diameter reduction of nodules in group B was greater than that of group A and the difference was statistically significant[(1.5±0.6)cm vs(1.4±0.8)cm,P<0.05

关 键 词：回顾性研究 甲状腺结节 消融技术 乙醇 

分 类 号：R653[医药卫生—外科学]