甲状腺与下颌下腺结节同期微波消融治疗的初步尝试

Percutaneous microwave for simultaneous ablation of concomitant thyroidal and submandibular nodules

目的尝试进行甲状腺和下颌下腺结节的同期微波消融治疗,总结临床经验。方法 57岁男性患者超声诊断右侧下颌下腺区、右侧甲状腺无痛性结节,大小分别为10mm×10mm×9mm、13mm×11mm×10mm,采用超声引导下穿刺活检及超声引导下同期一次性微波消融治疗,观察近期疗效。结果手术顺利完成,右侧下颌下腺结节消融时间约185s,右侧甲状腺结节消融时间约72s,总手术时间约20min。术中无出血、水肿、神经损伤等并发症。术后2个月随访,患者未出现面神经、舌神经、喉返神经受损的相关临床表现,无口腔干燥现象。超声检查见消融区均缩小,超声造影时保持无增强状态。结论微波消融治疗适用于颈部多器官结节性疾病的联合治疗,符合微创、节约、高效的治疗原则,值得进一步临床尝试。

Objective To use ultrasound guided percutaneous microwave for simultaneous ablation of a nodule in submandibular gland and another in the ipsilateral thyroid gland. Methods A 57-year old man presented non-painful nodules in his right submandibular gland and right thyroid lobe simultaneously, with the sizes being 10 mm× 10 mm× 9 mm and 13 min× 11 min× 10 mm separately. Percutaneous microwave ablation and biopsy were conducted for both nodules simultaneously under ultrasound guidance. The short-term effects were documented both clinically and ultrasonographieally. Results The ablation therapy was completed uneventfully and took a total of 20 rain. The ablation time was 185 seconds for the submandibular nodule and 72 seconds for the thyroid nodule. No intra operative complications such as bleeding, edema or nerve injury were observed. No symptoms of injuries to the facial nerve, glossal nerve or recurrent laryngeal nerve were observed during a 2-month follow up. Ultrasound examination revealed that the ablated area was shrank and kept unenhanced on CEUS. Conclusion Microwave ablation therapy is suitable for the conjoint treatment of concomitant nodular lesions in multiple neck organs. The method is economical, efficient, minimally invasive, and is worth of more clinical practices.