超声介导微波消融术对甲状腺良性结节患者甲状腺相关激素的影响

Effect of ultrasound-mediated microwave ablation on thyroid related hormones in patients with benign thyroid nodules

目的探讨超声介导微波消融术在甲状腺良性结节患者中的治疗效果及对甲状腺相关激素的影响。方法选择2020年1月—2023年1月收治的甲状腺良性结节患者200例为研究对象,按随机数字表法分为两组(各100例)。对照组采取开放手术治疗,观察组采用超声介导微波消融术治疗,评估两组患者治疗效果,比较两组手术指标,手术前及术后7 d炎性因子、甲状腺相关激素水平,以及术后并发症、复发发生情况。结果观察组手术、住院时间、术中出血量及住院费用均低于对照组(P<0.05)。术后7 d,两组均伴有不同程度炎性反应,但观察组超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、肾上腺素(E)及去甲肾上腺素(NE)水平均低于对照组(P<0.05);两组术后7 d均伴有甲状腺相关激素水平升高,但观察组促甲状腺素(TSH)、血清游离三碘甲腺原氨酸(FT_(3))、血清游离甲状腺素(FT_(4))水平均低于对照组(P<0.05)。观察组手术并发症、术后残留、术后瘢痕、复发的发生率分别为2.00%、2.00%、1.00%、2.00%,低于对照组的10.00%、8.00%、6.00%、8.00%(P<0.05)。结论超声介导微波消融术用于甲状腺良性结节患者中效果良好,在减少手术创伤、降低术后并发症中具有一定优势,且对甲状腺激素和炎性因子的影响较小,值得推广应用。

Objective To explore the therapeutic effect of ultrasound-guided microwave ablation in patients with benign thyroid nodules and its impact on thyroid related hormones.Methods A total of 200 patients with benign thyroid nodules admitted from January 2020 to January 2023 were selected as study subjects.They were divided into two groups by random number table method,with 100 patients in each group.The control group received open surgery treatment,while the observation group received ultrasound-guided microwave ablation treatment.Treatment outcomes were evaluated in both groups,including surgical indicators,preoperative and postoperative 7 d inflammatory factors and thyroid related hormones,and incidence of postoperative complications and recurrence.Results The observation group had lower surgery time,hospital stay,intraoperative bleeding volumn,and hospitalization costs than the control group(P<0.05).Both groups had varying degrees of inflammatory reactions 7 d after surgery,but the observation group showed lower levels of hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-alpha(TNF-α),epinephrine(E),and norepinephrine(NE)than the control group(P<0.05).Both groups had elevated levels of thyroid related hormones 7 d after surgery,but the levels of thyroid stimulating hormone(TSH),serum free triiodothyronine(FT_(3)),and serum free thyroxine(FT_(4))in the observation group were lower than those in the control group(P<0.05).The incidence rates of surgical complications,postoperative residuals,postoperative scars,and recurrence in the observation group were 2.00%,2.00%,1.00%,and 2.00%,respectively,which were lower than those in the control group(10.00%,8.00%,6.00%,and 8.00%,respectively)(P<0.05).Conclusion Ultrasound-mediated microwave ablation is effective in treating patients with benign thyroid nodules,has advantages in reducing surgical trauma and postoperative complications,and has little impact on thyroid hormones and inflammatory factors,which is worth promoting and applying.