超声引导下微波消融术与开放手术在甲状腺结节治疗中效果的比较

Effect comparsion between microwave ablation guided by ultrasound and open surgery in the treatment of hyroid nodules

目的:比较超声引导下微波消融术与传统开放手术治疗甲状腺结节的效果。方法:选择100例诊断为甲状腺结节需要手术治疗的病人,根据病人意愿分为微波消融组(50例,采用超声引导下微波消融术)和传统手术组(50例,采用传统开放手术),对2组病人手术时间、术中出血量、术后住院时间、术后并发症发生率、美容效果以及术后12 h白细胞介素(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)水平进行比较。结果:微波消融术后美容效果明显优于传统手术;微波消融组手术时间、术中出血量和术后住院时间均明显少于传统手术组(P <0. 01);微波消融组术后并发症发生率为4. 00%,与传统开放手术组的12. 00%差异无统计学意义(P> 0. 05);术后12 h,微波消融组CRP、IL-6、和TNF-α水平均明显低于传统手术组(P <0. 01)。结论:超声引导下微波消融治疗甲状腺结节与传统手术相比手术时间更短,创伤更小,术后不留瘢痕,恢复快,疗效确切,具有较强的临床应用价值。

Objective： To compare the operative effect between microwave ablation guided by ultrasound and traditional open surgery in treating thyroid nodules.Methods： A total of 100 cases with benign thyroid nodules were divided into the microwave ablation group（50 cases,treated with microwave ablation guided by ultrasound） and traditional group（50 cases,treated with traditional open surgery） according to patients′ intention.The operation time,intraoperative blood loss,postoperative hospitalization time,incidence rate of complications,cosmetic effect,and serum levels of interleukin-6（IL-6）,C-reactive protein（CRP） and tumor necrosis factor-α（TNF-α） after 12 h of surgery were compared between two groups.Results： The cosmetic effect in microwave ablation group was better than that in traditional group.The operation time,intraoperative blood loss,postoperative hospitalization time in microwave ablation group were significantly less than those in traditional group（ P 〈0.01）.The difference of the incidence rate of complication between microwave ablation group（4.00%） and traditional group（12.00%） was not statistically significant（ P 〉0.05）.After 12 h of operation,the levels of IL-6,CRP and TNF-α in microwave ablation group were significantly lower than those in traditional group（ P 〈0.01）.Conclusions： Compared with traditional operation,the microwave ablation guided by ultrasound in treating thyroid nodules has short time,minimal invasion,rapid recovery,good curative effect and no scar,which has strong clinical application value.