两种治疗方法对低风险甲状腺微小乳头状癌的短期疗效观察  

Short Term Efficacy of Two Therapies for Low-risk Papillary Thyroid Microcarcinoma

作　　者：陈吉东[1] 岳林先[2] 陈琴[1] 顾毅[2] 张惠[1] Chen Jidong;Yue Linxian;Chen Qin;Gu Yi;Zhang Hui(Department of Ultrasound Medicine,Sichuan Provincial People’s Hospital,Chengdu 610072,China;Department of Vascular and 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]四川省人民医院血管甲状腺外科,成都610072

出　　处：《成都医学院学报》2021年第2期153-156,160,共5页Journal of Chengdu Medical College

基　　金：四川省科技厅重点研发项目(No:2020YFS0406)。

摘　　要：目的对比两种治疗方法对低风险甲状腺微小乳头状癌(PTMC)的短期临床疗效。方法回顾性分析四川省人民医院2013年3月至2018年5月经病理证实的232例单发低风险PTMC患者的临床资料,根据患者意愿分为消融组和切除组,消融组122例,行经皮微波消融;切除组110例,行开放式外科切除。观察消融组病灶缩小率及消失率,对比观察两组有效率、操作时间、住院时间、激素水平、并发症、局部复发率、新发率和淋巴结转移率。结果两组有效率均为100.00%,均无局部复发;第1、3、6、12、24个月,消融组病灶平均体积、病灶缩小率及病灶消失率组内比较差异有统计学意义(P<0.05);操作时间、住院时间、激素水平及并发症组间比较,差异有统计学意义(P<0.05);两组新发率及淋巴结转移率比较,差异无统计学意义(P>0.05)。结论微波消融和外科切除均能安全有效治愈低风险PTMC,消融更微创高效且并发症更少,故微波消融有望成为该类患者的另一种治愈方案。Objective To compare the short-term efficacy of two different therapies for low-risk papillary thyroid microcarcinoma(PTMC).Methods The clinical data of 232 patients with single low-risk PTMC confirmed by pathology in Sichuan Provincial People’s Hospital from March 2013 to may 2018 were retrospectively analyzed.The patients were divided into ablation group(n=122)and resection group(n=110)according to their wishes.Percutaneous microwave ablation was performed in ablation group while open surgical resection was performed in resection group.The reduction rate and disappearance rate of the lesion in the ablation group were observed.The effective rate,duration of operation,length of hospital stay,hormone level,complications,local recurrence rate,new occurrence rate and lymph node metastasis rate were compared between the two groups.Results The effective rate of both groups was 100%,and there was no local recurrence.At the 1 st,3 rd,6 th,12 th and 24 th months after treatment,there were significant differences in the mean volume,the reduction rate and the disappearance rates of lesions in the ablation group(P<0.05).There were statistically significant differences in duration of operation,length of hospital stay,hormone level and complications between the two groups(P<0.05).There was no statistically significant difference in the new incidence rate and lymph node metastasis rate between the two groups(P>0.05).Conclusion Both microwave ablation and surgical resection can cure low-risk PTMC safely and effectively.Since microwave ablation is less invasive,more efficient and with fewer complications,it is expected to be an alternative treatment for this kind of patients.

关 键 词：低风险甲状腺微小乳头状癌 经皮微波消融 手术切除 疗效 

分 类 号：R736.1[医药卫生—肿瘤] R653[医药卫生—临床医学]