超声引导下经皮激光消融治疗甲状腺良性结节的疗效及影响因素  

Efficacy and influence factor of ultrasound-guided percutaneous laser ablation for the treatment of benign thyroid nodules

作　　者：戴婷 刘稳刚[1] 周平[1] DAI Ting;LIU Wengang;ZHOU Ping(Department of Ultrasound,the Third Xiangya Hospital of Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院超声科,长沙市410013

出　　处：《临床超声医学杂志》2022年第11期870-873,共4页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(81871367);湖南省自然科学基金项目(2018SK21217)。

摘　　要：目的 探讨超声引导下经皮激光消融(PLA)治疗甲状腺良性结节的疗效,从结节超声特征方面分析其影响因素。方法 选取我院行超声引导下PLA治疗的甲状腺良性结节患者126例(共164个结节),术后2年内随访结节大小,评估并计算术后1、3、6、12、18、24个月病灶体积缩小率(VRR);以结节的超声特征(结节体积及性质)分别分类,应用多元线性回归分析其对PLA疗效的影响。结果 甲状腺良性结节PLA术后1、3、6、12、18、24个月VRR分别为20.9(36.7)%、45.7(44.6)%、75.4(36.8)%、92.0(18.5)%、94.0(15.9)%、95.8(15.6)%。不同性质结节术后1、3个月VRR比较差异有统计学意义(P<0.05),以囊性为主的结节VRR更高;不同体积结节术后6~24个月VRR比较差异均有统计学意义(均P<0.001),以≤5 ml的结节VRR更高。多元线性回归分析显示,结节体积是超声引导下PLA术后疗效的独立影响因素。结论 超声引导下PLA是治疗甲状腺良性结节的一项安全、有效的微创方法,结节体积是超声引导下PLA术后疗效的独立影响因素。Objective To explore the efficacy of ultrasound-guided percutaneous laser ablation(PLA)for the treatment of benign thyroid nodules,and to analyze the influence factor from the ultrasonic characteristics of nodules.Methods One hundred and twenty-six patients(164 nodules in total)with benign thyroid nodules treated by ultrasound-guided PLA in our hospital were selected.The volume of nodules were followed up within 2 years and the volume reduction rate(VRR)of lesion were evaluated and calculated at 1,3,6,12,18 and 24 months after operation.The ultrasonic characteristics of nodules(nodule volume and characters)were classified to analyze their effect on PLA efficacy.Results The VRR of benign thyroid nodules at1,3,6,12,18,24 months after PLA were 20.9(36.7)%,45.7(44.6)%,75.4(36.8)%,92.0(18.5)%,94.0(15.9)%,95.8(15.6)%,respectively.The different characters of thyroid nodules had significant differences in the VRR at 1 and 3 months after PLA(P<0.05),and the cystic nodules had higher VRR.The different volume of nodules had significant differences in the VRR at 6~24 months after PLA(all P<0.001),and nodules with volume≤5 ml had higher VRR.Multiple linear regression analysis showed that nodule volume was the independent influence factor for efficacy of ultrasound-guided PLA.Conclusion Ultrasoundguided PLA is a safe and effective minimally invasive therapy for the treatment of benign thyroid nodules,and the nodule volume is an independent factor affecting the efficacy of ultrasound-guided PLA.

关 键 词：超声引导 经皮激光消融 甲状腺结节 良性 疗效 影响因素 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]