射频消融甲状腺较大良性结节的并发症分析

Analysis of The Complications of Ultrasound-guided Radiofrequency Ablation for Larger Thyroid Benign Nodules

目的观察射频消融甲状腺较大良性结节的并发症发生、发展情况,探讨预防并发症的有效措施。方法对36 例甲状腺较大良性结节患者行超声引导下射频消融治疗,采用“液体隔离带法”预防毗邻结构受热损伤,观察患者并发症发生情况并分析降低其发生率的方法。结果 36 例患者均顺利完成射频消融治疗。术中并发症包括:颈部疼痛、出血、放射性牙痛、放射性耳根痛、放射性肩背痛等,患者可耐受,无需特殊处理,均可自愈。术后并发症包括声音减低和喉返神经损伤等,经对症处理后均好转。结论超声引导射频消融治疗甲状腺较大结节存在挑战,临床医生应全面了解可能发生的并发症,积累操作经验,把握“液体隔离带”的注入时机及注入量,预防及避免并发症的发生,以获得较好的治疗效果。

Objective To investigate the complications of ultrasound-guided radiofrequency ablation in the treatment of large benign nodules and analyze the prevention and treatment methods. Methods 36 patients underwent RFA by using “liquid-iso1ating maneuver”to avoid the perithyroid structures injury, and the features and treatment of complications were assessed. Results Intraoperative complications include neck pain, radioactive toothache, radioactive shoulder and back pain, etc., which can be tolerated by patients and self-healing without special treatment. Postoperative complications, including bleeding, voice loss and recurrent laryngeal nerve injury, improved after symptomatic treatment. Conclusion Ultrasoundguided radiofrequency ablation for the treatment of larger thyroid nodules is a challenge. Clinicians should fully understand the possible complications, accumulate operational experience, grasp the injection timing and amount of "liquid isolation zone", which can effectively prevent and avoid the occurrence of complications, so as to obtain a better therapeutic effect.