超声引导下微波消融治疗甲状腺微小乳头状癌

Clinical effect analysis on ultrasound-guided microwave ablation in the treatment of thyroid micropapillary carcinoma

目的探讨超声引导下微波消融术治疗甲状腺微小乳头状癌的临床效果。方法超声引导下细针穿刺活检确诊为甲状腺微小乳头状癌且彩超提示颈部无可疑转移淋巴结的20例患者,行超声引导下微波消融术。术后1个月复查甲状腺功能指标并记录并发症发生情况。术后1、3、6、12、18、24个月随访观察结节缩小、吸收情况,有无结节复发及颈部淋巴结转移情况。结果术后1个月复查甲状腺功能指标与术前比较差异有统计学意义。术后出现声音嘶哑1例,3个月后自行恢复正常,6例感咽部不适,给予雾化吸入数日后恢复正常。术后1、3、6个月甲状腺结节体积缩小率分别为57.8%、42.6%、80.5%。其中8例消融灶于术后12个月完全吸收,12例于术后18个月完全吸收。随访过程中未发现结节复发及颈部淋巴结转移。结论超声引导下微波消融术治疗甲状腺微小乳头状癌,为拒绝手术患者提供了一种新型微创治疗方法。其术后并发症少,甲状腺功能影响小,安全性高。

Objective To investigate the clinical effect of ultrasound-guided microwave ablation in the treatment of thyroid micropapillary carcinoma.Methods Ultrasound-guided fine needle biopsy confirmed 20 patients with micropapillary thyroid carcinoma and color Doppler ultrasonography showed above finding without suspected metastatic lymph nodes,thus ultrasound guided microwave ablation was performed on them.Thyroid function index and complications were reexamined and recorded 1 month after operation;then nodule reduced and absorpted whether has the nodule recurrence and the neck lymph node metastasis situation were observed after 1,3,6,12,18 and 24months follow-up.Results There was significant difference in thyroid function index compared with that before surgery 1 month after operation.Postoperative hoarseness occurred in 1 case,back to normal 3 months later,6 cases of pharynx discomfort,the aerosol inhalation was given back to normal after a few days.The reduction rate of thyroid nodule volume was 57.8%,42.6%,80.5%,respectively at 1,3and6 months after operation;of them 8 were completely absorbed at 12 months postoperatively,12 cases were completely absorbed at 18 months after operation.Nodule recurrence and cervical lymph node metastasis were not found during follow-up.Conclusion Ultrasound-guided microwave ablation in the treatment of thyroid micropapillary carcinoma as a new type of minimally invasive treatment is provided for the patients who refuse surgery.It has less postoperative complications,less influence on thyroid function,and its safety is high.