超声导向微波消融术与传统开放手术治疗甲状腺良性结节的临床效果比较

Effect of ultrasound guided microwave ablation on treatment of patients with benign thyroid nodules

目的比较超声导向微波消融术与传统开放手术治疗甲状腺良性结节的临床效果。方法回顾性分析2015-03~2017-02于该院治疗的甲状腺良性结节患者100例,根据治疗方式不同分为开放手术组和微波消融术组,各50例。开放手术组给予传统开放手术治疗,微波消融术组给予超声导向微波消融术治疗,比较两组患者肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)、C反应蛋白(Creactionprotein,CRP)、甲状腺功能及并发症发生情况。结果术前两组患者TNF-α、IL-6、CRP水平差异均无统计学意义(P>0.05),术后12 h微波消融术组TNF-α、IL-6、CRP水平均低于开放手术组,差异有统计学意义(P<0.01);术前、术后1个月两组患者游离三碘甲状腺原氨酸(free Triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)、促甲状腺激素(thyroid stimulating hormone,TSH)水平均无统计学意义(P>0.05);微波消融术组伤口疼痛、切口黏连、术中出血发生率低于开放手术组,放射性疼痛发生率高于开放手术组,差异有统计学意义(P<0.05)。结论超声导向微波消融术治疗甲状腺良性结节患者,能减轻手术创伤,效果显著,安全可靠,值得临床推广。

Objective To study the effect of ultrasound guided microwave ablation on treatment of patients with benign thyroid nodules.Methods 100 patients with benign thyroid nodules were selected in our hospital from March 2015 to February 2017 and were divided into the observation group(n=50)and the control group(n=50)according to the different operation modes.The control group was given open surgery,while the observation group were given ultrasound guided microwave ablation.The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reaction protein(CRP),thyroid function and complications were compared between the two groups.Results There were no significant differences in the preoperative levels of TNF-α,IL-6 and CRP between the two groups(P>0.05).The levels of TNF-α,IL-6 and CRP in the observation group were significantly lower than those in the control group 12 hours after the operation(P<0.01).There were no significant differences in the levels of free triiodothyronine(FT3),free thyroxine(FT4)and thyroid stimulating hormone(TSH)between the two groups before and after the operation(P>0.05).The incidence rates of wound pain,adhesion of incision and intraoperative bleeding in the observation group were significantly lower than those in the control group(P<0.05).The incidence of radioactive pain in the observation group was significantly higher than that of the control group(P<0.05).Conclusion Ultrasound guided microwave ablation is safe and can reduce the surgical trauma effectively for the patients with benign thyroid nodules.