超声引导经皮激光消融治疗复发性结节性甲状腺肿的效果

Efficacy of ultrasound-guided percutaneous laser ablation for recurrent nodular goiter

目的探讨超声引导下经皮激光消融(PLA)治疗复发性结节性甲状腺肿(RNG)的可行性。方法 RNG患者10例均为单个复发,超声引导下行PLA。术后1、3、6个月均行超声随访,观察结节体积变化,监测血清T_3、FT_3、T_4、FT_4和TSH水平,记录并发症。结果 10例患者均成功进行PLA治疗。术后1个月,结节较术前缩小[(5.19±1.04)ml vs.(7.29±1.50)ml](P<0.05);术后3、6个月分别进一步缩小至(4.49±0.90)ml和(3.53±0.71)ml(P<0.05)。超声造影显示消融区无灌注;未见明显并发症;治疗前后甲状腺相关激素水平无明显变化(P>0.05)。结论超声引导下PLA治疗RNG是一种微创、安全、有效的方法。

Objective To investigate the feasibility of ultrasound-guided percutaneous laser ablation（PLA）for recurrent nodular goiter（RNG）.Methods Ten patients with single RNG were treated with ultrasound-guided PLA.The volume of the nodes and thyroid functions were followed up by conventional ultrasonography and contrast-enhanced ultrasonography in the 1^（st）,3^（rd） and 6^（th） month after operation.The PLA-related complications were observed.Results PLA was performed successfully in all patients.The volume of the nodes was less in the 1^（st） month after PLA than that before[（5.19±1.04）ml vs.（7.29±1.50）ml]（P〈0.05）,which decreased further to（4.49±0.90）ml and（3.53±0.71）ml in the 3rd and 6th month after PLA,respectively（P〈0.05）.The area of ablation showed no perfusion at 48 hours after PLA.There were no obvious complications during and after operation.Serum levels of T_3,FT_3,T_4,FT_4 and TSH were not significantly changed after PLA compared to before（P〉0.05）.Conclusion Ultrasound-guided PLA is a safe and effective minimally invasive treatment for RGN.