甲状腺结节性病变经皮热消融治疗的近期疗效评价

Percutaneous thermal ablation for nodular thyroid diseases: an assessment of short-term effects

目的探讨超声引导与监测下经皮穿刺微波、射频消融治疗甲状腺结节性病变的近期临床效果。方法采用南京康友Thy-ablation型冷循环微波针及德国Celon-ProBreath单针双极式射频电极针在超声引导下经皮穿刺消融治疗甲状腺结节性病变104例(共289枚结节),观察治疗后的近期效果和不良反应及其并发症。结果 289枚结节均达到完全灭活,部分结节消融后获得了病理诊断结果,光镜下显示消融区为无滤泡结构的坏死物质;消融后第3～6个月随访观察发现结节缩小率达100%,无一例发生严重并发症,仅1枚结节需要二次消融。结论超声引导下微波、射频原位消融治疗甲状腺结节性病变效果确切,创伤微小,操作简便,恢复迅速,可于门诊实施,值得临床推广。

Objective To investigate the short-term effects of ultrasound-guided percutaneous microwave ablation（MWA） and radiofrequency ablation（RFA） for treatment of thyroid nodules.Methods Totally 104 patients with 289 thyroid nodules underwent ultrasound-guided internal-cooled MWA and bipolar RFA in our department from July 2009 to January 2011.The outcomes of patients were closely assessed for a short-term of 6 months;the thermal ablation-related side-effects and complications were also discussed.Results Focal ultrasound images of the 289 thyroid nodules and the core-biopsy pathology findings of some nodules revealed complete coagulative degeneration of the ablated lesions.Follow-up for 3-6 months showed that sizes of all the nodules decreased to different extents.Only one nodule needed an extra ablation.No severe complications were observed.Conclusion The ultrasound-guided percutaneous MWA and RFA are effective,minimally invasive,easy to perform and can achieve rapid recovery.The methods can be used for out-patients with nodular thyroid diseases.