超声引导经皮穿刺聚桂醇注射治疗甲状腺囊肿的疗效观察

Clinical efficiency of ultrasound-guided percutaneous lauromacrogol injection therapy for thyroid cysts

目的 ：探讨超声引导下注射硬化剂聚桂醇治疗甲状腺囊肿的临床疗效及安全性。方法 ：采用超声引导经皮穿刺囊腔内注射聚桂醇,治疗甲状腺囊肿共78例。治疗前所有囊肿均接受甲状腺穿刺及细胞病理学检查,以排除恶性病变。治疗时尽量将囊液抽吸净,然后注入约1/3囊腔容积量的聚桂醇进行硬化治疗,每周1次,根据囊肿的缩小情况,共治疗1-4次。结果：178例囊肿共进行166次硬化治疗,3个月后囊肿容积平均缩小71.6%±35.3%,与治疗前相比有显著差异（P〈0.01）;治疗总有效率84.6%（66/78）,治愈率52.6%（41/78）;2不同容积大小的囊肿治愈率有统计学差异（P〈0.01）,容积〉5 m L的囊肿治愈率显著高于容积〈5 m L者（P〈0.01）,但不同容积囊肿的治疗有效率无统计学差异（P〉0.05）;3治疗前后患者甲状腺功能及甲状腺相关抗体滴度无显著变化;4治疗的并发症发生率低,无严重不良反应。结论：超声引导下注射聚桂醇治疗甲状腺囊性病变简单易行、临床效果好,不良反应少,可作为甲状腺囊肿的首选治疗方法之一。

Objective：To Investigate the clinical efficiency and safety of ultrasound-guided sclerosing lauromacrogol injection therapy for thyroid cysts. Methods：Clinical data of 78 patients with thyroid cysts underwent ultrasound-guided aspiration and pereutaneous lauromacrogol injections. All cysts were confirmed to be benign by fine-needle aspiration biopsy. Firstly, the complete aspiration of cystic contents was performed, and then lauromacrogol of approximately one third of the volume of thyroid cyst was injected into the cyst. We performed the therapy once a week, and the injection was repeated one to four times which depended on the reduction of the cysts. Results： 1. One hundred and sixty-six times of injections were performed for 78 thyroid cysts. Volume of thyroid cysts decreased averagely by 71.6% ± 35.3% three months later, and there was a significant statistical difference before and after the therapy（P 〈 0.01）. The completely cure rate was 52.6% （41/78）and the total effective rate was 84.6%（66/78）; 2. The completely cure rates were different among diverse groups（P 〈 0.01 ）. For the volume of cysts less than 5 mL, the completely cure rate was statistically lower than those above 5 mL, however, the statistical significance was not found in effective rate among different volume of thyroid cysts （P 〉 0.05） ;3. There was no obvious changes in thyroid function and titer of thyroid related antibodies after the therapy;4. The incidence of complications was low and no sever adverse effect was occured after therapy. Conclusion： Ultrasoundguided lauromacrogol injection is a feasible, effective and safe method, and can be chosen as the preferred therapy for thyroid cysts.