超声引导下射频消融甲状腺良性结节的方法及近期疗效

Method and short term efficacy of ultrasound-guided radiofrequency ablation of thyroid benign nodules

目的探讨超声引导下射频消融治疗甲状腺结节的方法、风险及近期疗效。方法对78例108个甲状腺良性结节行超声引导下射频消融治疗;结节毗邻颈部重要结构时,术中注射液体隔离带,将其与周边组织分离。术后采用CEUS评价消融效果;常规超声随访结节大小变化;记录术中及术后并发症的发生与转归。结果术中81个结节注射液体隔离带;术后超声造影显示101个结节无造影剂灌注,一次完全消融率93.52%(101/108);术后1、3、6、12及18个月结节体积缩小率分别为22.22%、50.83%、83.76%、91.45%和93.16%;33个结节(33/108,30.56%)在术后6～12个月完全消失。喉返神经损伤2例,药物治疗1.0～1.5个月后恢复。结论超声引导下射频消融治疗甲状腺良性结节效果好,并发症少,治疗风险低。

Objective To investigate the method, risk and short term efficacy of ultrasound-guided radiofrequency abla- tion （RFA） of thyroid benign nodules. Methods A total of 78 patients with 108 benign thyroid nodules underwent ultrasound-guided RFA, and liquid belt was injected to insulated the nodules which was adjacent to important structures in some cases. The therapeutic response to RFA was assessed by CEUS, and the volume indexes of nodules were measured with ultrasound during the follow-up. Intraoperative and postoperative complications were observed. Results The liquid belt was injected in 81 nodules. CEUS showed that 101 nodules did not enhance after RFA, and the complete ablation rate was 93.52% （101/108）. The volume of nodules decreased by 22.22%, 50.83%, 83.76%, 91.45% and 93.16% at l, 3, 6, 12 and 18 months after ablation, respectively, and 30.56% （33/108） of nodules disappeared 6 to 12 months after ablation. Two patients experienced dysphonia and vocal cord palsy related to the ablation procedure, and both recovered 1.0-1.5 months medication. Conclusion Ultrasound-guided RFA may be feasible and effective for treatment of thyroid benign nod- ules with less complications and risk.