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甲状腺良性结节微波消融和手术切除临床疗效和安全性对比分析

Clinical efficacy and safety of microwave ablation and surgical resection of benign thyriod nodules:Comparative study

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【作者】 李柯伶马亦龙

【Author】 LI Keling;MA Yilong;Department of Interventional Therapy,Affiliated Tumor Hospital of Guangxi Medical University;

【机构】 广西医科大学附属肿瘤医院介入科

【摘要】 目的对比分析甲状腺良性结节患者微波消融和手术切除的临床效果和安全性。方法收集100例甲状腺良性结节患者影像和临床资料,其中微波消融术治疗44例53个结节(消融组),外科手术治疗56例60个结节(手术组)。比较2组患者治疗后1、3、6、12个月结节消退率,观察结节体积随时间变化趋势,并比较2组术后不良反应、住院时间等情况。结果消融组治疗后1、3、6、12个月结节消退率分别为54.55%、72.73%、95.45%、95.45%,手术组均为100%,治疗后1、3个月结节消退率消融组低于手术组(P均<0.001),治疗后6、12个月结节消退率2组间差异无统计学意义(P均=0.245)。消融组术后结节体积随时间呈下降趋势,6个月前结节体积缩小幅度较大,6个月后结节体积缩小幅度降低。消融组术后甲状腺功能低下发生率低于手术组(P=0.019),血肿、感染、声音嘶哑、甲状旁腺损伤发生率2组间差异无统计学意义(P均>0.05)。消融组平均住院时间短于手术组(t=-8.499,P=0.001)。结论微波消融技术治疗甲状腺良性结节能保证疗效,且并发症少、创伤小、住院时间短,其临床应用前景广阔。

【Abstract】 Objective To compare the clinical curative effect and security between microwave ablation treatment and surgical resection of benign thyroid nodules.Methods The imaging and clinical data of 100 cases of patients with benign thyroid nodules were collected,44 cases with 53 nodules were treated by microwave ablation treatment(ablation group),and 56 cases with 60 nodules were treated by surgical resection(surgery group).The rates of nodule regression in 1,3,6,12 months after treatment,the size and changes of benign thyroid nodules in patients treated with microwave ablation therapy,as well as postoperative adverse reactions,time of inhospital were observed.Results The rates of nodule regression in 1,3,6,12 months therapy group were 54.55%,72.73%,95.45%,95.45%,while the rates in surgeny group were 100%.In the 1,3 months after treatment,the rates of nodule regression in ablation group were lower than those in surgery group(both P<0.001).In the 6,12 months after treatment,the rates had no statistically significant differences in both groups(both P=0.245).With the extension of observation time,the nodule volume of the patients treated with microwave ablation therapy had a tendency to continue to shrink,particularly in the first 6months.The incidence of hypothyroidism in ablation group was lower than surgery group(P=0.019).The difference of the incidence s of hematoma,infection,voice hoarse,parathyroid injury were not statistically significant in both groups(all P>0.05).The time of inhospital in ablation group was obviously shorter than that in surgery group(t=-8.499,P=0.001).Conclusion Microwave ablation treatment of benign thyroid nodules has guaranteed results.It has the following advantages such as less complications,small trauma,short hospitalization time.So it has a broad prospect in clinical application.

【关键词】 甲状腺结节良性微波消融并发症
【Key words】 Thyroid nodulesBenignMicrowave ablationComplication
  • 【文献出处】 中国介入影像与治疗学 ,Chinese Journal of Interventional Imaging and Therapy , 编辑部邮箱 ,2017年08期
  • 【分类号】R653
  • 【被引频次】47
  • 【下载频次】251
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