微波消融技术在甲状腺结节患者治疗中的效果及对甲状腺功能的影响研究

Microwave ablation for patients with thyroid nodules and its influence on thyroid function

目的探讨微波消融技术在甲状腺结节患者中的临床效果及对血管内皮生长因子（VEGF）、微血管密度（MVD）的影响。方法2015年6月至2017年6月本院收治的甲状腺结节患者120例，随机数字法分为对照组（n=60）和观察组（n=60）。对照组采用常规甲状腺切除术治疗，观察组采用微波消融技术治疗，两组治疗过程中取病灶组织，采用酶联免疫吸附试验检测手术前、后甲状腺激素水平，比较两组临床效果及对血管内皮生长因子、微血管密度的影响。结果观察组围术期出血量、手术时间、住院时间及手术瘢痕长度，均少（短）于对照组（均P〈O．05）；两组术前甲状腺水平比较差异无统计学意义（P〉0．05）；观察组术后FT3为（9．32±1．24）pmol/L，TSH为（2．73±0．51）uIU/L，均低于对照组的（9．31±1．23）pmoL/L及（2．64±0．56）uIU/L，均P〈0．05，观察组术TT4水平的（2．39±0．63）pmol／L，高于对照组（P〈0．05）；观察组术后并发症发生率低于对照组（P〈0．05）。结论将微波消融技术用于甲状腺结节患者中效果理想，有助于提高结节消退率，改善血管内皮生长因子、微血管密度，值得推广应用。

Objective To investigate the clinical effect of microwave ablation for patients with thyroid nodules and its effects on vascular endothelial growth factor （VEGF） and microvessel density （MVD）. Methods 120 patients with thyroid nodules treated at our hospital from June, 2015 to June, 2017 were retrospectively analyzed. The patients were randomly divided into a control group （n=60） and an observation group （n=60）. The control group were treated with conventional thyroidectomy and the observation group with microwave ablation. The pathological tissue of both groups was got during the treatment. The thyroid hormone levels were detected by ELISA before and after operation. The clinical efficacy and the effects on vascular endothelial growth factor and microvessel density were compared between these two groups. Results The bleeding volume, operation time, hospitalization time, and postoperative scar length were shorter in the observation group than in the controlgroup （all P 〈 0.05）. There were no statistical differences in thyroid hormone levels between the 2 groups before operation （P 〉 0.05）. The levels of FT and TSH were lower and the level of TT4 was higher in the observation group than in the control group [ （39.32±1.24） pmol/L vs. （9.31±1.23） pmol/L, （2.73±0.51） ulU/ L vs. （ 2.64±0.56 ） ulU/L, and （2.39±0.63） pmol/Lvs. （1.75±0.43） pmol/L, all P 〈 0.05]. The incidence of complications was lower in the observation group than in the control group （P 〈 0.05）. Conclusion Microwave ablation for patients with thyroid nodules is effective and can improve the nodular regression rate, vascular endothelial growth factor and MVD, so it is worth being generalized.