超声引导下射频消融术治疗甲状腺良性结节不同年龄段患者的临床效果观察  

The clinical effect of ultrasound-guided radiofrequency ablation in the treatment of benign thyroid nodules in patients of different ages

作　　者：高金辉[1] 黄子慧[1] 王芷乔 钱佳燕 李辉斌[1] GAO Jinhui;HUANG Zihui;WANG Zhiqiao;QIAN Jiayan;LI Huibin

机构地区：[1]南京市中西医结合医院,江苏南京210014

出　　处：《中医临床研究》2023年第27期16-21,共6页Clinical Journal Of Chinese Medicine

基　　金：南京市医药卫生科研课题(YKK20162)。

摘　　要：目的:分析超声引导下射频消融术治疗甲状腺良性结节不同年龄段患者的临床效果,指导临床治疗方案选择。方法:选取南京市中西医结合医院2019年1月―2020年12月收治的215例良性甲状腺结节患者,其中18~44岁为青年组126例(58.60%),45~59岁为中年组38例(17.67%),60岁以上为老年组51例(23.72%)。并对三组患者甲状腺结节体积缩小率、总有效率、甲状腺功能指标、并发症的发生率进行比较分析。结果:术后1个月,三组间比较甲状腺结节体积缩小率差异无统计学意义(P>0.05);而术后3个月、6个月、12个月,青年组结节体积缩小率显著高于中年组、老年组(P<0.05,P<0.01或P<0.001),同时中年组结节缩小率均显著高于老年组(P<0.05)。青年组的总有效率(97.6%)高于中年组(86.8%)与老年组(76.5%),差异具有统计学意义(P<0.05);三组患者术后12个月甲状腺功能及并发症发生率与治疗前比较均差异无统计学意义(P>0.05)。结论:超声引导下射频消融术治疗不同年龄段良性甲状腺结节疗效比较,年龄越大,甲状腺结节体积缩小率越小,其差异有统计学意义(P<0.05),但自身体积缩小率差异性不大。机体清除坏死组织主要依赖巨噬细胞吞噬,吞噬的快慢和多少依其吞噬能力的强弱,而老年人单核巨噬细胞吞噬功能减退,结节体积缩小率小。临床上可通过能提高巨噬细胞吞噬功能的药物及手段来提高消融术后体积缩小率。Objective:To analyze the clinical effect of ultrasound-guided radiofrequency ablation in the treatment of patients with benign thyroid nodules at different ages,and guide the selection of clinical treatment plans.Methods:A total of 215 patients with benign thyroid nodules admitted to Nanjing Integrated Traditional Chinese and Western Medicine Hospital from January 2019 to December 2020 were selected,including 126 cases(58.60%)aged 18-44 years old in the youth group,38 cases(17.67%)aged 45-59 years old in the middle-aged group,and 51 cases(23.72%)aged over 60 years old in the elderly group.The reduction rate of thyroid nodule volume,total effective rate,thyroid function index and incidence of complications were compared and analyzed among the three groups.Results:At 1 month,there was no statistically significant difference in the reduction rate of thyroid nodule volume among the three groups;At 3,6,and 12 months after surgery,the reduction rate of nodule volume in the young group was significantly higher than that in the middle-aged and elderly groups(P<0.05,P<0.01,or P<0.001),while the reduction rate of nodule volume in the middle-aged group was significantly higher than that in the elderly group(P<0.05);The total effective rate of the youth group(97.6%)was higher than that of the middle-aged group(86.8%)and the elderly group(76.5%),with a statistically significant difference(P<0.05);There was no significant difference in thyroid function and incidence of complications among the three groups of patients at 12 months after surgery compared to before treatment(P>0.05).The total effective rate in the young group(97.6%)was higher than that in the middle-aged group(86.8%)and elderly group(76.5%),and the difference was statistically significant(P<0.05).There were no significant differences in thyroid function and complication rate among the three groups 12 months after operation and before treatment(P>0.05).Conclusion:The effect of ultrasound-guided radiofrequency ablation on benign thyroid nodules of different ages wa

关 键 词：良性甲状腺结节 超声下射频消融术 临床疗效 

分 类 号：R653[医药卫生—外科学]