超声引导下经皮微波消融治疗甲状腺良性结节的疗效观察

Application of ultrasound-guided percutaneous microwave ablation treatment in patients with benign thyroid nodules

目的探讨超声引导微波消融治疗甲状腺良性结节的安全性及有效性。方法对甲状腺良性结节患者456例共912枚结节行超声引导下微波消融治疗。消融前对所有患者的甲状腺功能、结节容积及临床症状进行评估，并在术后第1、3、6、12个月进行随访，监测甲状腺结节容积变化和不良反应及并发症。结果912枚结节消融后超声造影均显示无造影剂填充，呈“黑洞征”。消融术后平均随访时间为（9±6）个月（3--24个月）。消融术后6个月，实性结节、混合性结节及囊性结节容积缩减率分别为（61±50）％、（81±33）％、（89±46）％。手术过程顺利，所有患者耐受性良好，11例病例（2．4％）出现可逆性声音改变，未发生严重并发症。结论超声引导下经皮微波消融治疗甲状腺结节安全可行，效果可靠，值得临床推广。

Objective To investigate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules. Methods A total 456 patients （912 nodules） underwent microwave ablation in our department. Microwave ablation was carried out using microwave antenna under local anesthesia. Nodule volume, thyroid function and clinical symptoms were evaluated before treatment and at 1,3,6 and 12 months after the treatment to monitor changes in the volume,adverse effect and complications. Results 912 nodules were all studied with contrast-enhanced ultrasound immediately after the ablation,and all results showed ＂black hole＂ sign. The mean follow-up period after microwave ablation was （9 ± 6）months （range,3 - 24 months）. At 6-month follow-up, the mean volume reduction ratio of the solid nodules, mixed nodules and the cystic nodules was （61 ± 50） %, （81 ± 33 ）%, （89 ± 46 ）%, respectively. The treatment was well tolerated and no major complications were observed except pain and transient voice changes （2.4%）. Conclusions Microwave ablation is a safe and effective technique for the treatment of benign thyroid nodules.