甲状腺射频消融术临床疗效研究

The Comparison Study of Thyroid Radiofrequency Ablation with Traditional Surgery

目的探讨甲状腺射频消融术与传统甲状腺手术对良性甲状腺结节的临床治疗效果及运用价值。方法 2014年10月至2017年8月共527例术前诊断良性甲状腺结节且有手术指征的患者,根据病情及患者意愿,分别行甲状腺射频消融术和传统手术,并回顾性对比研究其临床效果。射频消融组共187例,其中行单侧射频消融术42例,双侧射频消融术145例。传统手术组共340例,行单侧甲状腺手术84例,双侧甲状腺手术256例。结果对比单侧或双侧甲状腺手术,甲状腺射频消融术组较传统甲状腺手术组,手术时间及住院时间更短,手术切口更小,术中不适感更小,术后出血、声音嘶哑、饮水呛咳、手足抽搐、甲状腺功能减退等并发症更少,术后疤痕更小,但住院费用更高,差异有统计学意义(P<0.01),经术后1~2年随访,结节残留率及复发率两组比较无明显差异(P>0.05)。结论甲状腺射频消融术具有手术时间短、创伤小、愈合快、安全美观等特点,对于甲状腺良性结节的治疗是一种安全有效的方式,值得推广。

Objective To investigate the clinical effect and application value of radiofrequency ablation and traditional thyroid surgery for benign thyroid nodules.Methods From October 2014 to August 2017,527 patients with benign thyroid nodules were treated with radiofrequency ablation (RFCA) and conventional operation according to the need of the disease and the wishes of the patients.There were 187 cases in the radiofrequency ablation group,including 42 cases of unilateral radiofrequency ablation and 145 cases of bilateral radiofrequency ablation.There were 340 cases in the traditional operation group,in which 84 cases underwent unilateral thyroidectomy and 256 cases bilateral thyroid surgery.Results Compared with the unilateral or bilateral thyroid surgery,it was proved the radiofrequency ablation group of shorter operation time and hospital stay,the smaller incision,the lower discomfort feeling,and the lower incidence of postoperative bleeding and hoarseness.In the radiofrequency ablation group,there were fewer complications such as cough in drinking water,convulsion of hand and foot,hypothyroidism and less scar after operation but the cost of hospitalization was higher and the difference was statistically significant(P<0.05).After 1~2 years follow-up,there was no significant difference in the rates of thyroid nodule residue and recurrence between the two groups(P>0.05).Conclusion Radiofrequency ablation is a safe and effective method for the treatment of benign thyroid nodules.