超声引导下微波消融联合聚桂醇硬化治疗甲状腺混合性结节  

Sclerotherapy of the combination of ultrasound-guided microwave ablation and Lauromacrogol for mixed thyroid nodules

作　　者：沈睿[1] 程蓉岐[1] 贡翊斐 周恒花[3] 徐菲 岑栩敏[1] 袁劼 吴燕萍 王小平[2] 张宇[2] 蔡惠群[2] SHEN Rui;CHENG Rong-qi;GONG Yi-fei(Department of Ultrasound,Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;不详)

机构地区：[1]上海中医药大学附属上海市中医医院超声科,上海200071 [2]上海中医药大学附属上海市中医医院外二科,上海200071 [3]上海交通大学医学院附属第九人民医院病理科,上海200011

出　　处：《中国医学装备》2021年第5期87-91,共5页China Medical Equipment

基　　金：国家中医药管理局科技项目中药领域2018年度项目(2018ZY03005)“新型中药凝胶治疗中医外科疾病的临床多中心研究”;上海中医药大学预算内项目(探索类18ST093)“聚桂醇注射液对兔甲状腺破坏与修复作用的研究”。

摘　　要：目的:探讨超声引导下微波消融联合聚桂醇泡沫硬化法对甲状腺混合性结节治疗的安全性和有效性,以及该术式的临床价值。方法:选取在医院就诊的119例甲状腺混合性结节患者,分别对结节实性成分进行微波消融,对囊性区域进行抽液、聚桂醇注射液灌洗及泡沫剂硬化处理。测量术中及术后第1个月、3个月、6个月和12个月时结节体积缩小率(VRR),观察对比术中、术后并发症情况。结果:在119例患者中共135个甲状腺混合性结节术后均达到完全消融。治疗后1个月、3个月、6个月和12个月时结节体积逐渐减小,VRR逐渐增加,其差异具有统计学意义(F=992.438,F=4841.756;P<0.001)。术后所有患者甲状腺功能均恢复正常,其中3例复发,均无严重并发症发生。结论:超声引导下微波消融联合聚桂醇硬化法对甲状腺混合性结节的疗效肯定,其手术创伤小、用时短且并发症低,是一种安全有效的治疗方法。Objective:To explore the safety and effectiveness of the sclerotherapy of the combination of ultrasoundguided microwave ablation and Lauromacrogol foam in treating mixed thyroid nodules and the clinical value of this surgical method.Methods:119 patients with mixed thyroid nodules who admitted to hospital were selected.And microwave ablation was used to their solid components,and the sclerotherapy was performed in cystic region by abstracting fluid,perfusion of Lauromacrogol injection and foaming agent.The volume reduction ratios(VRR)of nodule during surgery,and at the 1th month,the third month,the 6th month and 12th month post operation were measured respectively.And the intraoperative and postoperative complications were further observed and compared.Results:A total of 135 mixed thyroid nodules from 119 patients achieved complete ablation after the surgery.The nodule volume gradually diminished from the first month,the third month and the 6th month to the 12th months after surgery,and the VRR gradually increased during this period,and the differences of those between them were significant(F=992.438,F=4841.756,P<0.001).The thyroid functions of all patients post operation recovered to normal,while 3 cases of them occurred recurrence.And there was no severe complication in them.Conclusion:The curative effect of the sclerotherapy of the combination of ultrasound-guided microwave ablation and Lauromacrogol for mixed thyroid nodules is affirmed,and it has series of advantages includes small surgical trauma,shorter surgical time and lower complication.Therefore,it is a safely and effectively therapeutic method.

关 键 词：甲状腺结节 微波消融 聚桂醇 硬化治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学]