超声引导微波消融术与开放式手术治疗甲状腺良性大结节的临床疗效比较  

Comparison of Clinical Efficacy of Ultrasound-Guided Microwave Ablation and Open Surgery for Large Benign Thyroid Nodules

作　　者：郑斌[1] 高峰[1] 李静艳[1] 魏玮 刘何利 黄梅[1] 张震 Zheng Bin;Gao Feng;Li Jingyan;Wei Wei;Liu Heli;Huang Mei;Zhang Zhen(Department of Ultrasound,Hebei Province Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou 061001,China)

机构地区：[1]河北省沧州中西医结合医院超声科,沧州061001

出　　处：《成都医学院学报》2024年第2期294-297,共4页Journal of Chengdu Medical College

基　　金：河北省卫生健康委员会医学科学研究基金(No:20210957)。

摘　　要：目的 比较超声引导微波消融(MWA)术与开放式手术治疗甲状腺良性大结节的临床效果。方法 选取2020年4月至2022年4月在沧州中西医结合医院收治的96例甲状腺良性大结节患者为研究对象,按照随机数字表法将其分为开放组(实施开放式手术)和MWA组(实施超声引导MWA术),每组48例。比较两组手术相关指标、结节清除率、甲状腺激素水平、术后并发症发生情况。结果 与开放组相比,MWA组手术时间、术中失血量、术后住院天数更少(P<0.05),术后24 h NRS评分更低(P<0.05)。术后6个月两组结节清除率比较,差异无统计学意义(P>0.05)。促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)在组间及时间的主效应比较,差异有统计学意义(P<0.05)。与开放组相比,术后3、6个月MWA组TSH明显降低(P<0.05),FT3、FT4明显升高(P<0.05)。MWA组并发症发生率(4.17%)低于开放组(18.75%)(P<0.05)。结论 超声引导MWA术与开放式手术对甲状腺良性大结节的治疗效果均较好,但超声引导MWA术在减少手术时间、术后并发症及住院时间方面具有优势,并能充分保留甲状腺功能。Objective To compare the clinical efficacy of ultrasound-guided microwave ablation(MWA)and open surgery in the treatment of large benign thyroid nodules(BTN).Methods A total of 96 patients with large BTN admitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from April 2020 to April 2022 were selected as the study objects.They were randomly divided into either an open group(n=48,open surgery)or an MWA group(n=48,ultrasound-guided MWA).The operation related indexes,nodule clearance rate,thyroid hormone levels and postoperative complications were compared between the two groups.Results Compared with the open group,the MWA group had shorter duration of operation,less intraoperative blood loss,shorter postoperative hospital stay(P<0.05),and lower numerical rating scale(NRS)score at 24 h after operation(P<0.05).There was no statistically significant difference in nodule clearance rates between the two groups at 6 months after operation(P>0.05).There were significant differences in the main effects of thyroid stimulating hormone(TSH),free triiodothyronine(FT3),and free thyroxine(FT4)between the two groups and different time points(P<0.05).At 3 and 6 months after operation,compared with the open group,the MWA group had decreased TSH but increased FT3 and FT4(P<0.05).The incidence of complications in the MWA group(4.17%)was lower than that in the open group(18.75%)(P<0.05).Conclusion Both ultrasound-guided MWA and open surgery are effective in the treatment of large BTN.However,ultrasound-guided MWA has advantages in shortening duration of operation,reducing postoperative complications and shortening hospital stay,and can fully retain thyroid function.

关 键 词：微波消融 开放式手术 甲状腺良性大结节 并发症 

分 类 号：R581[医药卫生—内分泌] R445.1[医药卫生—内科学]