超声引导穿刺无水乙醇硬化治疗老年良性甲状腺囊肿疗效观察

Efficacy of Ultrasound Guided Percutaneous Ethanol Sclerotherapy for Benign Thyroid Cysts in Elder Patients

目的探讨超声引导经皮穿刺注射无水乙醇硬化治疗老年良性甲状腺囊肿的疗效。方法分析2007年1月—2009年12月我科收治的因心肺功能障碍难以行手术治疗的老年良性甲状腺囊肿患者32例,在超声引导下行囊肿穿刺抽液后注射无水乙醇进行硬化治疗,定期超声观察其疗效。结果治疗中5例患者注射乙醇后出现烧灼样刺痛或胀痛,持续3～15 min后缓解;3例出现持续性疼痛不适,给予口服止痛药3 d后缓解,无其他严重并发症发生。32例患者中1例证实为甲状腺乳头状癌,其余31例患者术后3个月复查超声,25例患者甲状腺囊肿治疗有效,有效率为80.64%,6例行第2次治疗;半年后复查超声,30例患者甲状腺囊肿治疗有效,总有效率为96.77%,1例多发囊肿行第3次治疗。随访2年,超声显示31例患者甲状腺囊肿治疗均有效。结论超声引导经皮穿刺无水乙醇注射治疗心肺功能障碍老年良性甲状腺囊肿是一种安全、有效的治疗方法。

Objective To evaluate the efficacy and safety of ultrasound guided pereutaneous ethanol sclerotherapy for benign thyroid cysts in elder patients. Methods 32 elder patients with benign thyroid cysts admitted to our department from Jan- uary 2007 to December 2009 were analyzed. These patients could not be given surgery due to eardiopulmonaxy dysfunction. They were given ultrasound guided ethanol selerotherapy and were followed up by sonography to observe the efficacy. Results During treatment, five cases had pain of burning sensation or distending pain and remitted after 3 to 15 minutes. Three eases had persis- tent pain and remitted three days after taking painkiller per os. No other severe complications occurred. Of the 32 eases, one ease was confirmed as thyroid papillary carcinoma and other 31 cases were given ultrasound reexamination after three months, which showed 25 patients with thyroid cysts had therapeutic effect with an effective rate of 80. 64% and six other patients were giv- en second time treatment. The patients were given ultrasound reexamination after six months, with 30 patients with thyroid cysts having therapeutic effect with an effective rate of 96. 77%. One case had multiple cysts and was given third time treatment. All the patients were followed up for two years, and ultrasound showed that the treatment in 31 patients with thyroid cysts was effec- tive. Conclusion Ultrasound guided ethanol sclerotherapy is a safe and effective treatment for benign thyroid cysts in elder pa- tients with cardiopulmonary dysfunction.