切除术和超声消融治疗甲状腺良性结节的效果及安全性比较  

Comparison of efficacy and safety between resection and ultrasound ablation for benign thyroid nodules

作　　者：赵康[1] 汪梅花 杨花荣[1] ZHAO Kang;WANG Meihua;YANG Huarong(Department of Throatology,Yan′an University Affiliated Hospital,Yan′an,Shaanxi 716000,China)

机构地区：[1]延安大学附属医院鼻咽喉科,陕西延安716000

出　　处：《检验医学与临床》2022年第21期2907-2910,共4页Laboratory Medicine and Clinic

基　　金：陕西省延安市科技计划项目(7902013Y0011)。

摘　　要：目的探讨高强度聚焦超声消融技术与锁骨上侧入路改良小切口甲状腺切除术治疗甲状腺良性结节患者对促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)的影响及安全性分析。方法选取2019年1月至2021年1月延安大学附属医院咽喉科收治的甲状腺良性结节患者178例作为研究对象,按治疗方法不同将其分成消融组和切除组,各89例。消融组实施高强度聚焦超声消融技术治疗。切除组实施锁骨上侧入路改良小切口甲状腺切除术治疗。利用SPSS21.0软件处理各项数据,比较两组治疗前、治疗后3个月时的TSH、T3表达水平及两种治疗方法的安全性。结果两组治疗后3个月时的TSH、T3表达水平均显著改善(P<0.05);消融组治疗后3个月时TSH表达水平高于切除组,T3表达水平低于切除组(P<0.05)。消融组手术时间、术后住院时间均短于切除组(P<0.05)。切除组并发症发生率为15.38%,消融组并发症发生率为2.56%,差异有统计学意义(P<0.05)。消融组共有94个结节,消融一次成功率为93.61%(88/94);术后1、3、6、12个月,消融组患者结节体积均不同程度缩小且均小于术前,差异有统计学意义(P<0.05)。结论高强度聚焦超声消融技术与锁骨上侧入路改良小切口甲状腺切除术均可有效改善甲状腺良性结节患者TSH、T3表达水平;与锁骨上侧入路改良小切口甲状腺切除术治疗比较,高强度聚焦超声消融技术治疗可明显缩短手术时间和术后住院时间,降低T3表达水平和并发症发生率;术后结节消融成功率可观,结节体积均不同程度缩小。Objective To investigate the effect and safety of high-intensity focused ultrasound ablation technique and modified small incision thyroidectomy with supraclavicular approach on thyroid stimulating hormone(TSH)and triiodothyronine(T3)in patients with benign thyroid nodules.Methods A retrospective experiment was performed on 178 patients with benign thyroid nodules admitted to the Department of Throatology,Yan′an University Affiliated Hospital from January 2019 to January 2021.According to the treatment method,they were divided into ablation group and resection group,with 89 cases in each group.The ablation group was treated with high-intensity focused ultrasound ablation technique,and the resection group was treated with modified small incision thyroidectomy with supraclavicular approach.SPSS21.0 software was used to process the data.The expression levels of TSH and T3 before treatment and 3 months after treatment and the safety of the two treatment methods were compared between the two groups.Results The expression levels of TSH and T3 were significantly improved in both groups at 3 months after treatment(P<0.05);At 3 months after treatment,TSH expression level in ablation group was higher than that in excision group,and T3 expression level was lower than that in excision group(P<0.05).The operative time and postoperative hospital stay in the ablation group were shorter than those in the resection group(P<0.05).The complication rate was 15.38%in the resection group and 2.56%in the ablation group,and the difference was statistically significant(P<0.05).There were 94 nodules in the ablation group,and the success rate of ablation was 93.61%(88/94).At 1,3,6,and 12 months after operation,the volume of nodules in the ablation group was reduced to different degrees and was smaller than that before operation,and the differences were statistically significant(P<0.05).Conclusion Both high-intensity focused ultrasound ablation technique and modified small incision thyroidectomy with supraclavicular approach can effective

关 键 词：切除术 高强度聚焦超声消融 甲状腺良性结节 促甲状腺激素 

分 类 号：R445.1[医药卫生—影像医学与核医学]