超声引导下经皮微波消融术与传统开放手术治疗甲状腺良性结节的疗效及预后对比  

Efficacy and prognosis of ultrasound-guided percutaneous ablation and traditional open surgery in the treatment of benign thyroid nodules:a comparative study

作　　者：马灿业 杨帆[1] 李宝金 刘长珠 MA Canye;YANG Fan;LI Baojin;LIU Changzhu(Department of Hepatobiliary Surgery,the 8^(th)Affiliated Hospital of Guangzhou Medical University,Guangzhou 510000,China;不详)

机构地区：[1]广州医科大学附属市第八人民医院,广东广州510000

出　　处：《现代医院》2021年第7期1107-1109,1112,共4页Modern Hospitals

基　　金：广东省医学科学技术研究基金(A2019300)。

摘　　要：目的探究超声引导下经皮消融术与传统开放手术治疗甲状腺良性结节的疗效及预后差异。方法回顾性选取2017年1月—2020年8月于本院就诊治疗的甲状腺良性结节患者103例,根据其自愿采取的手术方式将患者分为消融组53例(83个结节)和开放组50例(85个结节),消融组采取超声引导下经皮消融术进行消融治疗,开放组采取传统开放手术进行切除治疗,比较两组围手术期相关指标、临床手术疗效、甲状腺功能及术后并发症差异。结果消融组手术时间、术后住院时间明显短于开放组,术中出血量明显低于开放组(P<0.05);术后1个月、3个月、6个月,消融组结节清除率分别为32.53%、61.44%、97.59%,开放组结节清除率为100%,术后1、3个月,消融组结节清除率明显低于开放组(P<0.05),但术后6个月比较差异无统计学意义(P>0.05);术后1个月,消融组血清促甲状腺激素(TSH)水平明显低于开放组,游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)水平明显高于对开放组(P<0.05);消融组血肿、感染、声音嘶哑、切口瘢痕等并发症总发生率明显低于开放组(P<0.05)。结论超声引导下经皮消融术治疗甲状腺良性结节最终疗效与传统开放手术疗效相近,都能达到较高结节清除率,但超声引导下经皮消融术对于患者甲状腺功能影响较小,患者术后并发症发生率低,预后良好,值得临床推广应用。Objective To compare the efficacy and prognosis of ultrasound-guided percutaneous ablation and traditional open surgery in the treatment of benign thyroid nodules.Methods This study retrospectively enrolled 103 patients with benign thyroid nodules treated in the hospital from January 2017 to August 2020.According to the surgical method,the patients were divided into two groups:the ablation group(53 patients with 83 nodules)and the open group(50 cases with 85 nodules).The ablation group was treated with ultrasound-guided percutaneous ablation,and the open group was treated with traditional open surgery.Relevant perioperative indicators,clinical effects,thyroid function and postoperative complications were compared between the two groups.Results The operation time and postoperative hospital stay of the ablation group were significantly shorter than those of the open group,and the intraoperative blood loss was significantly less than that of the open group(P<0.05).1 month,3 months,and 6 months after operation,the nodule removal rates in the ablation group were 32.53%,61.44%,and 97.59%.The nodule removal rate in the open group was 100%.The nodule removal rate in the ablation group was significantly lower than that in the open group at 1 month and 3 months after operation(P<0.05),but there was no statistically significant difference at 6 months after operation(P>0.05).1 month after operation,serum thyroid-stimulating hormone(TSH)level in the ablation group was significantly lower than that in the open group,while the levels of free triiodothyronine(FT3)and free thyroxine(FT4)were significantly higher than those in the open group(P<0.05).The total incidence of complications such as hematoma,infection,hoarseness,and incision scar in the ablation group was significantly lower than that in the open group(P<0.05).Conclusion Ultrasound-guided percutaneous ablation has similar curative effect to traditional open surgery in the treatment of benign thyroid nodules,and both of them can achieve a higher nodule removal rate.Howev

关 键 词：甲状腺良性结节 经皮消融术 超声引导 疗效 预后 

分 类 号：R581[医药卫生—内分泌]