微波消融术在甲状腺结节内出血治疗中的疗效评估  

The effect of microwave ablation for treating thyroid nodule hemorrhage

作　　者：王艺苑 刘磊[1] 王丁悦 黄崑[1] WANG Yi-yuan;LIU Lei;WANG Ding-yue;HUANG Kun(Department of Ultrasound,the First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院超声科,辽宁沈阳110001

出　　处：《中国临床医学影像杂志》2023年第6期399-402,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:通过对超声引导下甲状腺结节内出血微波消融术后疗效的分析,探讨微波消融技术治疗甲状腺结节内出血的临床价值。材料与方法:选取我院2020年1月—2021年6月行超声引导下微波消融治疗的患者84例(共84个囊实混合性结节)。所有患者术前均行超声造影及细胞病理学检查明确为囊性为主的出血性良性结节。术后1~12月进行随访,观察结节的大小变化,并进行统计学分析,同时以每个月结节的体积及体积缩小率为依据进行t检验,明确微波消融术后的最佳评估时间。结果:①共84例患者,随访84例,所有患者均随访1年以上。患者术后疼痛4例(4.76%),出血5例(5.95%),声音嘶哑6例(7.14%),头痛8例(9.52%),呕吐1例(1.19%),低血糖1例(1.19%),麻醉剂过量1例(1.19%)。②术后1月甲状腺结节体积与术前相比无统计学差异(P>0.05),术后2~12月甲状腺结节体积分别与术前相比有统计学差异(P均<0.05)。③通过t检验明确术后7月甲状腺结节大小趋于稳定,为最佳评估时间。结论:微波消融术对甲状腺结节内出血止血效果明显,术后并发症少,体积缩小明显,术后7月体积缩小率趋于稳定,可以用于临床推广。Objective:To analyze the treatment effect of ultrasound-guided microwave ablation for thyroid intranodular hemorrhage,and to explore the clinical application value of this technique.Materials and Methods:From January 2020 to June 2021,84 patients(84 cystic solid mixed nodules)who underwent ultrasound-guided microwave ablation in our hospital were enrolled.Each patient was identified as cystic hemorrhagic benign nodule by contrast-enhanced ultrasound and cy-topathological examination before operation.The patients were followed up at one,two,three,four,five,six,seven,eight,nine,ten,11 and 12 months after operation in order to observe the size changes of nodules.At the same time,t-test was carried out based on the volume and volume reduction rate of nodules every month to determine the best evaluation time after mi-crowave ablation.Results:①A total of 84 patients were followed up for more than one year.There were postoperative pain in four cases(4.76%),bleeding in five cases(5.95%),hoarseness in six cases(7.14%),headache in eight cases(9.52%),vomiting in one case(1.19%),hypoglycemia in one case(1.19%),and excessive anesthetic in one case(1.19%).②There was no significant difference in the volume of thyroid nodules between one month after operation and before operation(P>0.05).There was a sig-nificant difference in the volume of thyroid nodules between 2~12 months after operation and before operation(P>0.05).③The sizes of thyroid nodules tended to be stable seven months after operation,which was the best evaluation time.Conclusion:Microwave ablation has an obvious treatment effect on thyroid nodules hemorrage,with less postoperative complications and significant volume reduction rate.The volume reduction rate tends to be stable seven months after operation,which can be used for clinical promotion.

关 键 词：甲状腺结节 消融技术 超声检查 介入性 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]