甲状腺结节治疗中应用超声引导下射频消融术的疗效分析

Ultrasound-guided radiofrequency ablation in treatment of thyroid nodule

目的探讨甲状腺结节治疗中应用超声引导下射频消融术的疗效。方法收集本院2013年1月至2015年4月收治的甲状腺结节患者240例，行前瞻性研究并随机分为两组，每组120例，对照组给予传统射频消融术，实验组则应用超声引导行射频消融术，比较两组患者不同类型结节体积变化情况、不同类型结节治疗效果情况与甲状腺功能指标变化情况。结果两组患者术后3个月囊性为主[（1．72±0．49）vs．（2．68±0．51）]、实性为主[（1．65±0．45）vs．（2．59±0．48）]与囊实混合类型[（1．59±0．41）vs．（2．42±0．43）]体积组间比较差异有统计学意义（P〈0．01）；实验组患者囊性为主（100．00％）、实性为主（90．00％）与囊实混合（95．24％）治疗总有效率均明显高于对照组（70．59％、76．14％、79．07％），差异具有统计学意义（P〈0．05）；两组患者术后3个月FT3[（5．42±0．55）VS．（5．35±0．61）]、FT4[（16．65±1．87）vs．（16．49±1．88）]与TSH水平[（1．99±0．78）vs．（2．01±0．73）]分别与治疗前进行组内比较，差异不具有统计学意义（P〉0．05）。结论甲状腺结节治疗中应用超声引导下射频消融术的疗效显著，具有借鉴性。

Objective To investigate the curative effect of ultrasound-guided radiofrequency ablation in the treatment of thyroid nodule. Methods 240 patients with thyroid nodule admitted into our hospital from January, 2013 to April ,2105 were selected for prospective analysis and were divided into a control group and an experimental group, 120 cases for each group. The control group were treated with conventional radiofrequency ablation and the experimental group ultrasound-guided radiofrequency ablation. The changes in the volume of different types of thyroid nodules, the curative effects on different types of thyroid nodules, and the changes in the indicators of thyroid function of these two groups were compared. Results 3 months after the operation, there were statistical differences （P〈0.01） in the two groups＇ volume comparison： the mainly cystic type [（1.72±0.49） vs. （2.68±0.51）], the mainly solid type [（1.65±0.45） vs. （2.59±0.48）], and the mixed type [（1.59±0.41） vs. （2.42±0.43）]; in the experimental group, the total effective rates of the mainly cystic type was 100.00%, the mainly solid type 90.00%, and the mixed type 95.24%, which were all higher than those in the control group（70.59%, 76.14%, and 79.07%）, with statistical differences （P〉0.05）; there were no statistical differences （P〉0.05） in the levels of FT3 [（5.42±0.55） vs. （5.35±0.61）], FT4 [（16.65±1.87） vs. （16.49±1.88）], and TSH [（1.99±0.78） vs. （2.01±0.73）]of these two groups between before and 3 months after the operation. Conclusions The curative effect of ultrasound-guided radiofrequency ablation in the treatment of thyroid nodule is significant. This treatment regimen may be used for reference in clinical practice.