超声引导下甲状腺良性结节微波消融术后短期疗效的影响因素分析  

Analysis of factors influencing short-term outcomes after ultrasound-guided microwave ablation of benign thyroid nodules

作　　者：徐皙婷 林鹏 韦舒静 杨红[2] Xu Xiting;Lin Peng;Wei Shujing;Yang Hong(Department of Ultrasound,The Fifth Affiliated Hospital of Guangxi Medical University,Nanning 530022,China;Department of Ultrasound,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第五附属医院超声科,南宁530022 [2]广西医科大学第一附属医院超声科,南宁530021

出　　处：《广西医科大学学报》2022年第10期1635-1641,共7页Journal of Guangxi Medical University

基　　金：广西南宁市科学研究与技术开发计划项目(No.20153333)。

摘　　要：目的:探讨甲状腺良性结节行超声引导下微波消融术(MWA)术后最佳短期随访时机和影响术后短期疗效的相关因素。方法:回顾性分析2019年1月至2020年12月在广西医科大学第一附属医院、第五附属医院超声科行甲状腺结节MWA治疗的甲状腺疾病患者92例,共118个结节。于术后1个月、3个月进行随访,记录各结节两期三径大小,计算结节体积和体积缩小率(VRR)。采用单因素分析及多因素Logistic回归分析分析影响MWA术后3个月结节VRR的危险因素。结果:118个结节术后1个月、3个月体积均缩小,与术前对比及术后1个月、3个月对比差异均有统计学意义(均P<0.001)。Logistic回归分析显示,实质性结节(OR=0.266;95%CI:0.095~0.542)及小结节(OR=5.847;95%CI:2.443~13.992)是影响MWA术后3个月VRR的危险因素(P<0.05)。结论:甲状腺结节的大小、内部成分比和结节的位置是影响WMA短期疗效的因素,将MWA术后具有实际意义的短期随访时间定在术后3个月,更有利于MWA治疗价值的体现。Objective:To investigate the optimal timing of short-term follow-up after ultrasound-guided microwave ablation(MWA)of benign thyroid nodules and the factors associated with the effect of short-term postoperative outcomes.Methods:A retrospective analysis of 92 patients with thyroid disease who underwent microwave ablation of thyroid nodules at the Department of Ultrasound of the First Affiliated Hospital and Fifth Affiliated Hospital of Guangxi Medical University from January 2019 to December 2020 was conducted,with a total of 118nodules.Follow-up was performed at 1 month and 3 months after the operation.The length,breadth,and width of each nodule at both times were recorded,and the nodule volume and volume reduction rate(VRR)were calculated.One-way analysis and multi-factor logistic regression were used to analyze the risk factors affecting the nodal VRR at 3 months after MWA.Results:All 118 nodules decreased in size at 1 month and 3 months after surgery,with statistically significant differences compared with the preoperative figures and between 1 month and3 months after surgery(all P<0.001).Logistic regression analysis showed that substantial nodules(OR:0.266;95%CI:0.095-0.542)and small nodules(OR:5.847;95%CI:2.443-13.992)were risk factors affecting VRR at3 months after MWA(P<0.05).Conclusion:The size of thyroid nodules,internal component ratio,and location of nodules are the factors affecting the short-term efficacy of WMA.Setting the practically meaningful short-term follow-up after MWA at 3 months postoperatively represents the therapeutic value of microwave ablation more effectively.

关 键 词：甲状腺良性结节 微波消融术 体积缩小率 影响因素 

分 类 号：R581[医药卫生—内分泌]