【作者】 张毅；

【导师】 孙尧；

【作者基本信息】 山东大学 ， 影像医学与核医学（专业学位）， 2016， 硕士

【摘要】 目的：本研究旨在比较射频消融、微波消融、激光消融三种热消融方式治疗良性甲状腺结节的疗效差异,探讨治疗良性甲状腺结节的优选方案。方法：回顾研究我院2013年1月至2014年12月35例40个甲状腺良性结节的临床治疗数据,比较射频消融、微波消融、激光消融三种热消融方式治疗甲状腺良性结节的疗效差异。在消融治疗后1个月、3个月、6个月、12个月定期随访,分别对进行患者彩超检查、实验室检查和临床症状评估。使用SPSS20.0数理统计软件对所有患者的治疗效果进行统计分析。结果：射频消融、微波消融、激光消融三种热消融方式对治疗良性甲状腺结节均有显著疗效,12个月后结节体积缩减率分别为94.7%、93.8%、90.1%。比较热消融治疗大结节(结节体积>10mL)临床疗效发现,射频消融或微波消融治疗效果显著优于激光消融治疗(p=0.007,P<0.05)。比较热消融治疗小结节(结节体积<1mL)临床疗效,12个月后结节体积缩减率分别为82.6%、82.4%、82。4%,三者无显著性差异(P>0.05)。结论：热消融具有安全、有效、微创的特点,较外科手术更易为患者接受,用于甲状腺结节的治疗能避免手术创伤大、形成瘢痕的缺点,尤其适用于手术风险较高和不愿接受外科手术的患者。对于结节体积较大的患者建议选择射频消融或微波消融,对与结节体积较小的患者建议选择激光消融。对于大结节先使用射频消融或微波消融治疗后,在后期检查中,发现未完全消融的小结节使用激光消融,这样可以极大的发挥各自的优势。总之,热消融治疗时间短,消融时间均在十几到几十分钟内就能完成,住院时间短,极大地缩短了治疗周期,减少患者疼苦和负担的同时,也将大大增加医院的效益,具有极高的临床应用价值。更多还原

【Abstract】 Object:To compare the efficacy differences of the radiofrequency ablation, microwave ablation and laser ablation for the treatment of thyroid nodule. Discussion preferred embodiment of the treatment of benign thyroid nodules.Methods:Ultrasound-guided laser ablation was performed in 35 patients with 40 benign thyroid nodules from January 2014 to December 2015 in our hospital. We compare the efficacy differences of the radiofrequency ablation, microwave ablation and laser ablation for the treatment of thyroid nodule. Respectively, in a month,3 months,6 months,12 months after the ablation patients were followed up regularly. The patient is subjected to ultrasound examination, laboratory tests and clinical assessment of symptoms.Result:The results of three thermal ablation for the treatment of benign thyroid nodules way have a significant effect. After 12 months, nodule volume reduction rates were 94.7%、93.8%、90.1%. Comparison of thermal ablation large nodules (nodule volume>10mL) found that the clinical efficacy of radiofrequency ablation or microwave ablation effect is significantly superior to laser ablation (p=0.007, P <0.05). Comparison of thermal ablation of small nodules (nodule volume<1mL) clinical efficacy found that they are no significant difference between the three (P >0.05). After 12 months, nodule volume reduction rates of radiofrequency ablation, microwave ablation, laser ablation were 82.6%、82.4%、82.4%.Conclusion:In summary, the hermal ablation is safe, effective, minimally invasive, beautiful. Ultrasound-guided thermal ablation for treatment of benign thyroid nodules can avoid the shortcoming of surgical trauma, form disease of mark, especially have a higher risk for surgery and in patients undergoing surgery, in particular, unwilling to accept higher surgical risk surgical patients.For patients with bulky nodules, we suggest that the choice of radiofrequency ablation or microwave ablation, with nodules smaller volume, we recommend choosing laser ablation.Using radiofrequency ablation or microwave ablation patients with benign thyroid nodules, but follow-up ultrasound, found incomplete ablation, laser ablation may be used at this time, so can greatly play their respective advantages. Thermal ablation treatment time is short. It were able to complete within 10 minutes, after 24 hours observation can be discharged, greatly shortening the treatment period, while reducing the burden on the patient pain and suffering, but also will greatly increase the efficiency of the hospital. Thermal ablation treatment of benign thyroid nodules have high application value and should be popularized.更多还原