注射“液体隔离带”对超声引导下射频消融治疗甲状腺结节患者颈部结构损伤的影响

The Effect of Injection of Liquid Isolation Belt on Cervical Structural Damage in Patients Undergoing Ultrasound Guided Radio-frequency Ablation for Treating Thyroid Nodules

目的探析注射"液体隔离带"在超声引导下射频消融治疗甲状腺结节患者中的应用效果及对颈部结构损伤的影响。方法以91例甲状腺结节患者作为研究对象,将其随机分为观察组(46例)与对照组(45例)。两组均行超声引导下射频消融治疗,观察组在射频消融治疗基础上注射"液体隔离带"将喉返神经与腺体分离。比较两组治疗前后甲状腺功能(FT3、FT4及TSH)、术中及术后并发症及术后1个月、2个月、3个月的甲状腺结节体积缩小率。结果两组治疗前甲状腺功能指标差异无统计学意义(P>0.05),治疗后两组FT3、FT4均升高,TSH降低,组内治疗前后差异有统计学意义(P<0.05),但手术后甲状腺功能指标两组间差异不明显。观察组术中并发症发生率为4.3%(2/46),对照组为11.1%(5/45),差异无统计学意义(P>0.05);观察组术后并发症发生率为4.3%(2/46),对照组为17.8%(8/45),差异有统计学意义(P<0.05)。观察组术后1个月、2个月、3个月甲状腺结节体积缩小率均高于对照组,差异有统计学意义(P<0.05)。结论超声引导下射频消融的应用为甲状腺结节治疗的有效方法,但易引起喉返神经损伤等并发症,注射"液体隔离带",可有效预防该并发症,有利于保护患者颈部结构。

Objective To explore the application effect of injection of liquid isolation belt in ultrasound guided radiofrequency ablation for treating patients with thyroid nodules and the effect on cervical structural damage. Methods 91 patients with thyroid nodules treated in our hospital from February 2013 to August 2015 were taken as the research objects and were randomly divided into the observation group（ n= 46） and the control group（ n = 45）. The two groups were treated by ultrasound guided radiofrequency ablation. Based on this,the observation group were treated by liquid isolation belt. The thyroid function（ FT3,FT4 and TSH） before and after the treatment,intraoperative and postoperative complications and the minification rate of thyroid nodule volume in postoperative 1,2 and 3 months were compared between the two groups. Results There were no significant differences in thyroid function indexes between the two groups before the treatment（ P〉0. 05）. After the treatment,FT3 and FT4 in the two groups increased while TSH decreased. The before and after differences within group were statistically significant（ P〈0. 05）,which indicated that thyroid function of the two groups were improved,but the differences in thyroid function indexes between the two groups after operation were not significant. In the observation group,the incidence of intraoperative complications was 4. 3%（ 2 /46） while in the control group was 11. 1%（ 5 /45）（ P〉0. 05）; the incidence rate of postoperative complications in the observation group was 4. 3%（ 2 /46） while in the control group was 17. 8%（ 8 /45）（ P〈0. 05）. The minification rate of thyroid nodule volume in the observation group in postoperative 1,2 and 3 months were significantly higher than those in the control group（ P〈0. 05）. Conclusion The application of ultrasound guided radiofrequency ablation could be an effective method for treating thyroid nodules but it could easily lead to complications such as recurrent laryngeal nerve injury. The adjuvant application of injection of liquid isolation belt could effectively prevent such complications and protect the cervical structures of patients.