超声引导下经皮微波消融与无水酒精注射微创治疗囊实性良性甲状腺结节的临床疗效对比分析  

Clinical efficacy of ultrasound-guided microwave ablation and percutaneous ethanol injection in the treatment of benign solid-cystic thyroid nodules:a comparative study

作　　者：周麟 潘华锋 李琰 ZHOU Lin;PAN Huafeng;LI Yan(School of Medical,Wuhan University of Science and Technology,Wuhan 430081,China)

机构地区：[1]武汉科技大学医学院,430081 [2]武汉科技大学附属普仁医院

出　　处：《临床外科杂志》2021年第6期517-520,共4页Journal of Clinical Surgery

摘　　要：目的探讨超声引导下经皮微波消融与无水酒精注射微创治疗囊实性良性甲状腺结节的临床疗效。方法囊实性良性甲状腺结节病人140例,根据病人选择不同的微创治疗方法分为两组,观察组80例,采用超声引导下经皮微波消融治疗;对照组60例,采用超声引导下经皮无水酒精注射治疗。比较两组治疗术后1天并发症发生率,术后1天应激炎症反应指标(CRP、IL-6),甲状腺功能指标(TSH、FT3、FT4),术后1、3、6、9、12个月随访时结节体积缩小率,随访1年的治愈率及治疗总有效率。结果观察组术后1天并发症发生率(8.75%)低于对照组(35%),差异有统计学意义(P<0.05);观察组与对照组术后CRP、IL-6均升高,但观察组升高幅度较小,应激炎症反应较对照组轻,差异有统计学意义(P<0.05)。术后1天观察组甲状腺功能减退发生率(6.25%)低于对照组(23.33%),差异有统计学意义(P<0.05)。术后1、3、6、9、12个月随访时,观察组结节体积缩小率大于对照组,差异有统计学意义(P<0.05)。观察组随访1年的治愈率(72.50%)及治疗总有效率(90%)高于对照组(20.00%,68.33%),两组比较差异有统计学意义(P<0.05)。结论超声引导下经皮微波消融是目前治疗囊实性良性甲状腺结节较有效、损伤较轻且安全的一种微创方法。Objective To retrospectively analyze the clinical efficacy of ultrasound-guided microwave ablation and percutaneous ethanol injection in the treatment of benign cystic and solid thyroid nodules.Methods A retrospective analysis of 140 patients with benign cystic and solid thyroid nodules in our hospital was selected.The patients were divided into 2 groups according to different surgical methods,observation group(percutaneous microwave ablation treatment group)80 cases,control group(percutaneous absolute alcohol injection treatment group)60 cases.Compared the two groups of treatment methods 1 day postoperative complications,1 day postoperative stress inflammatory response indicators(CRP,IL-6),thyroid function indicators(TSH,FT3,FT4),nodule volume reduction rate at 1,3,6,9 and 12 months postoperative follow-up,cure rate and total effective rate of treatment at 1 year follow-up.Results The incidence of complications in the observation group(8.75%)was lower than that in the control group(35%),respectively(P<0.05);the observation group and the control group Postoperative CRP and IL-6 both increased,but the observation group had a smaller increase,and the stress inflammatory response was lighter than that of the control group(P<0.05).The incidence of hypothyroidism in the observation group(6.25%)was lower than that of the control group(23.33%)one day after surgery(P<0.05).At 1,3,6,9 and 12 months postoperative follow-up,the reduction rate of nodule volume in the observation group was greater than that in the control group(P<0.05).The cure rate(72.50%)and total effective rate of treatment(90%)in the observation group during the 1-year follow-up were higher than those in the control group(20.00%)and total effective rate(68.33%),with statistically significant difference(P<0.05).Conclusion Ultrasound-guided percutaneous microwave ablation is currently a minimally invasive method for the treatment of benign solid-cystic thyroid nodules with less damage and safety.

关 键 词：囊实性良性甲状腺结节 微波消融 经皮无水酒精注射 超声引导 

分 类 号：R653[医药卫生—外科学]