超声引导下微波消融术与传统开放手术治疗甲状腺良性结节临床效果  

Clinical Effects of Ultrasound-guided Microwave Ablation Versus Conventional Open Surgery for Benign Thyroid Nodules

作　　者：王克邪 李峰 陆伟逸 杨孙虎 WANG Kexie;LI Feng;LU Weiyi;YANG Sunhu(Shanghai Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200082,China)

机构地区：[1]上海市中西医结合医院,上海200082

出　　处：《北华大学学报(自然科学版)》2025年第3期355-360,共6页Journal of Beihua University(Natural Science)

基　　金：上海市虹口区卫生健康委员会医学科研课题(虹卫2303-03);上海市虹口区卫生健康委员会临床重点扶持专科项目(HKZK2020A03);上海市虹口区卫生健康委员会中医药科研面上项目(HKQ-ZYY-2020-06)。

摘　　要：目的探讨微波消融术与传统开放手术治疗甲状腺良性结节的临床效果和优势。方法依据不同的手术方法将60例甲状腺良性结节患者分为微波消融组(n=30)和传统开放手术组(n=30)。观察两组患者手术相关指标及甲状腺结节体积,并随访观察术后1、3、6和12个月的甲状腺结节体积,评估甲状腺结节体积的缩小率。同时,评估术后并发症及安全性。结果微波消融组的手术时间、术中出血量和住院时间低于传统手术组(P<0.05);微波消融术前,术后1、3、6和12个月甲状腺结节的体积分别为3.79(1.41~7.55)cm 3、1.49(0.53~3.27)cm 3、0.71(0.25~2.13)cm 3、0.51(0.11~1.93)cm 3和0.31(0.03~0.95)cm 3,体积缩小率的中位数分别为54.93%、75.95%、84.06%和93.26%(P<0.05);术后1 a体积缩小满意率≥80%的占83.33%;微波消融术后6个月存在美容问题的Ⅲ和Ⅳ类结节较术前均明显减少(P<0.001);微波消融术术后并发症发生率明显低于传统开放手术组(P<0.05),且两组患者术后均未出现复发情况。结论超声引导下微波消融术在治疗甲状腺良性结节方面效果良好,且在手术相关指标、术后并发症和术后疼痛方面具有明显优势,具有较高的临床应用价值。Objective To investigate the clinical effects and advantages of microwave ablation versus conventional open surgery for the treatment of benign thyroid nodules.Methods Based on different surgical methods,60 patients with benign thyroid nodules were divided into microwave ablation group(n=30)and conventional open surgery group(n=30).Surgery-related indexes and thyroid nodule volumes of patients in both groups were observed,and thyroid nodule volumes were followed up at 1,3,6 and 12 months after surgery to assess the reduction rate of thyroid nodule volume.Meanwhile,postoperative complications and safety were also assessed.Results The procedure time,intraoperative bleeding and hospital stay in microwave ablation group were lower than those in conventional surgery group(P<0.05).The volumes of thyroid nodules before microwave ablation and at 1,3,6 and 12 m onths after the procedure were 3.79(1.41~7.55)cm 3,1.49(0.53~3.27)cm 3,0.71(0.25~2.13)cm 3,0.51(0.11~1.93)cm 3,and 0.31(0.03~0.95)cm 3,respectively.The median volume reduction rates were 54.93%,75.95%,84.06%and 93.26%(P<0.05),respectively.The proportion of patients with volume reduction satisfaction rate≥80%at 1 a after procedure was 83.33%.The number of typeⅢandⅣnodules with cosmetic problems at 6 months after microwave ablation was significantly lower than that before procedure(P<0.001).The incidence of postoperative complications in microwave ablation group was significantly lower than that in conventional open surgery group(P<0.05),and there were no recurrences in either group after the procedure.Conclusion Ultrasound-guided microwave ablation is effective in the treatment of benign thyroid nodules,and has obvious advantages in surgical-related indicators,postoperative complications,and postoperative pain.It has high clinical application value.

关 键 词：微波消融术 传统开放手术 甲状腺良性结节 

分 类 号：R653[医药卫生—外科学]