超声引导下微小乳头状癌射频消融临床应用

Clinical application of ultrasound guided radiofrequency ablation for micro papillary carcinoma

目的探讨甲状腺微小乳头状癌患者采用超声引导下射频消融治疗的临床效果。方法收集本院甲状腺微小乳头状癌27例患者,所有患者均于超声引导下进行射频消融治疗。术后对患者进行为期1年的随访观察,经超声检查观察患者治疗后不同时间的消融灶变化、甲状腺实质与颈部淋巴结状况,以评估患者的临床疗效。结果本组27例患者术后均行为期1年的随访观察,超声检查显示患者的结节不断变小,治疗后首月、3月、半年及1年时患者的结节体积缩小率分别为22.22%、51.85%、85.19%、92.59%。治疗3月时消融灶消失者1例,治疗后半年时消融灶消失者2例,治疗后1年时消融灶消失者6例;其中有26例(96.3%)患者首次治疗后就达到了无瘤生存。治疗后1例患者出现局部复发,1例患者出现淋巴结转移,术后均未出现皮肤气道烫伤与喉返神经损伤等严重的并发症。结论甲状腺微小乳头状癌患者采用超声引导下射频消融治疗疗效显著,安全性较好,值得进一步推广。

Objective To analyze the clinical effect of ultrasound guided radiofrequency ablation in the treatment of papillary thyroid carcinoma. Methods 27 patients with thyroid papillary micro carcinoma were selected, all patients were under the guidance of ultrasound RF ablation. After a period of 1 year of follow-up, the changes of ablation lesions, thyroid parenchyma and cervical lymph nodes in patients after treatment were observed, and the clinical effect was evaluated. Results In this group of 27 patients after the period of 1 year of follow-up, uhrasonography displayed that nodule of patients become small, treatment after the first month, 3 months, six months and one year the nodule volume reduction ratio was respectively 22.22%, 51.85%, 85.19%, 92.59%. After the treatment for 3 months, 1 case disappeared, 2 cases disappeared after treatment in the first half of the year, 6 cases disappeared in one year after treatment, 26 cases （96.3 % ） were treated for the first time. Local recurrence occurred in 1 patient after treatment, 1 patient had lymph node metastasis, and no serious complications such as skin airway bums and recurrent laryngeal nerve injury occurred. Conclusion The curative effect of ultrasound guided radiofrequency ablation in the treatment of papillary thyroid carcinoma is significant, and the safety is good, it is worth to be further popularized.