评估射频消融对不同大小甲状腺良恶性结节的短期疗效  

Evaluation of the Short-Term Efficacy of RFA in Different Size of Benign and Malignant Thyroid Nodules

作　　者：崔文芳 马家莉 梁汝娜 王娟[1] 曹茹 何鑫[1] 姜珏[1] Cui Wenfang;Ma Jiali;Liang Runa;Wang Juan;Cao Ru;He Xin;Jiang Jue(Department of Ultrasound,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院超声科,西安市710004

出　　处：《中国超声医学杂志》2025年第1期4-8,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的评估超声引导下射频消融治疗对不同大小甲状腺良恶性结节的有效性和安全性。方法前瞻性收集接受射频消融的157例患者共252个结节,评估射频消融治疗后第1、第3、第6、第9个月时甲状腺结节横径、纵径的大小变化,直径缩小率和治愈率及治疗后出现的并发症。结果157例患者共252个甲状腺结节的横径、纵径在消融术后第1、第3、第6、第9个月逐渐减小,缩小率递增且其直径变化差异具有统计学意义;甲状腺微小乳头状癌第6个月时消失最多,≤5 mm甲状腺微小乳头状癌9个月时累积治愈率最高;甲状腺良性结节方面,≤15 mm良性结节第9个月累积治愈率为81.6%,而>15 mm良性结节第9个月难以通过射频消融达到完全治愈;≤10 mm甲状腺良性结节与≤10 mm甲状腺微小乳头状癌横径、纵径变化及结节累积治愈率差异均无统计学意义。结论超声引导下射频消融能够有效治疗甲状腺良恶性结节,尤其适用于≤5 mm甲状腺微小乳头状癌,治愈率最高。Objective To evaluate the efficacy and safety of ultrasound-guided radiofrequency ablation(RFA)in the treatment of different size benign and malignant thyroid nodules.Methods A total of 252 nodules in 157 patients who underwent radiofrequency ablation were selected.The size change in transverse and longitudinal diameter,diameter reduction rate and the cure rate of thyroid nodules at 1,3,6 and 9 months after radiofrequency ablation,and the complication occurrence after treatment were evaluated.Results The transverse and longitudinal diameter of 252 thyroid nodules were gradually decreased at the 1,3,6 and 9 months after ablation,the reduction rate was increased,and there were statistically significant differences in diameter changes.Papillary thyroid microcarcinoma disappeared mostly at 6 months,the highest cumulative cure rate of papillary thyroid microcarcinoma less and equal than 5mm was at 9 month.In term of benign thyroid nodules,the cumulative cure rate was 81.6%in nodules less and equal than 15 mm,and it were difficult to achieve complete cure by radiofrequency ablation in nodules more than 15 mm.There were no statistically significant differences in transverse and longitudinal diameter change and cumulative cure rate between benign nodules and papillary thyroid microcarcinoma less and equal than 10 mm.Conclusions Ultrasound-guided radiofrequency ablation can treat thyroid nodules effectively,especially with the highest cure rate in 5 mm papillary thyroid microcarcinoma.

关 键 词：甲状腺结节 超声引导下射频消融 甲状腺微小乳头状癌 甲状腺良性结节 

分 类 号：R736.1[医药卫生—肿瘤] R581[医药卫生—临床医学] R445.1