超声引导下经皮穿刺射频消融治疗甲状腺良性结节及PTMC的效果及对甲状腺激素水平的影响  

Effect of Ultrasound-guided Percutaneous Radiofrequency Ablation on Benign Thyroid Nodules and PTMC and Its Effect on Thyroid Hormone Levels

作　　者：伏秋梅 张静丽 缪峻芳 李小琼 孔祥如[2] FU Qiumei;ZHANG Jingli;MIAO Junfang;LI Xiaoqiong;KONG Xiangru(Department of Ultrasound,Shilin Yi Autonomous County People´s Hospital,Kunming,Yunnan Province,652200 China;Department of Oncologic Surgery,Children´s Hospital Affiliated to Chongqing Medical University,Chongqing,400014 China)

机构地区：[1]昆明市石林彝族自治县人民医院超声科,云南昆明652200 [2]重庆医科大学附属儿童医院肿瘤外科,重庆400014

出　　处：《世界复合医学》2022年第12期1-3,8,共4页World Journal of Complex Medicine

基　　金：重庆市科委技术创新与应用示范一般项目(cstc2018jscx-msybX0031)。

摘　　要：目的 探讨超声引导下射频消融术治疗甲状腺良性结节及甲状腺微小乳头状癌(papillary thyroid microcarcinoma, PTMC)对甲状腺激素水平的影响及术后治疗效果。方法 回顾性分析2019年6月—2021年6月于云南省昆明市石林彝族自治县人民医院就诊的41例甲状腺良性结节及PTMC患者的临床资料。所有患者均采用超声引导下射频消融术治疗,比较治疗前后FT3、FT4、TSH及甲状腺结节体积。结果 治疗12 h,患者甲状腺激素水平FT3(4.43±0.91)pmol/L高于治疗前(3.36±0.44)pmol/L;血清FT4(1.55±0.30)pmol/L高于治疗前(1.24±0.20)pmol/L,差异有统计学意义(t=7.27、7.33,P<0.05);治疗1、3、6个月患者的TSH与治疗前比较,差异无统计学意义(P>0.05)。患者的甲状腺结节体积治疗1个月(2.56±0.91)cm3、治疗3个月(1.68±0.86)cm3,治疗6个月(0.56±0.51)cm3与治疗前比较,差异有统计学意义(t=4.18、8.69、16.34,P<0.05)。结论 超声引导下射频消融治疗甲状腺良性结节并PTMC具有微创特点,术后可出现一过性FT3及FT4升高,特殊患者可适当关注甲状腺激素变化。Objective To explore the effect of ultrasound-guided radiofrequency ablation on thyroid hormone levels in benign thyroid nodules and PTMC.Methods Clinical data of 41 patients with benign thyroid nodules and PTMC admitted to Shilin Yi Autonomous County People´s Hospital from June 2019 to June 2021 were retrospectively analyzed.All patients were treated with ultrasound-guided radiofrequency ablation to compare FT3,FT4,TSH and thyroid nodule volume before and after treatment.Results After 12 h of treatment,the patient´s thyroid hormone level FT3(4.43±0.91)pmol/L higher than pre-treatment(3.36±0.44)pmol/L,and serum FT4(1.55±0.30)pmol/L higher than pretreatment(1.24±0.20)pmol/L,the difference was statistically significant(t=7.27,7.33,P<0.05);there was no statistically significant difference in TSH between 1 month,3 months and 6 months after treatment(P>0.05).Radiofrequency ablation for benign and malignant thyroid nodules has a volume of(2.56±0.91)cm3 one month after treatment,(1.68±0.86)cm3 three months after treatment,and(0.56±0.51)cm3 six months after treatment,compared with pre-treatment,the difference was statistically significant(t=4.18,8.69,16.34,P<0.05).Conclusion Ultrasound-guided radiofrequency ablation for the treatment of benign thyroid nodules and PTMC is minimally invasive,transient FT3 and FT4 increase may occur after surgery,and appropriate attention may be paid to thyroid hormone changes in special patients.

关 键 词：甲状腺良性结节 PTMC 射频消融术 甲状腺激素 

分 类 号：R445[医药卫生—影像医学与核医学]