超声引导下经皮微波消融对甲状腺良性结节的甲状腺激素水平及安全性的影响

Effect of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules on the thyroid hormone level and safety of patients

目的:探讨超声引导下经皮微波消融术在治疗甲状腺良性结节中对甲状腺激素水平的影响及微波消融对甲状腺良性结节病人的安全性。方法:选取收治175例甲状腺良性结节病人,分为观察者和对照组,观察组采用超声引导下经皮微波消融术治疗,对照组采用传统的甲状腺结节切除术。对比2组术前、术后甲状腺激素水平及术后并发症,分析不同治疗方法对甲状腺功能的影响和并发症的发生率比较。结果:治疗前,2组病人年龄、病程差异、结节数、TSH、FT3、FT4水平差异无统计学意义(P>0.05),对照组治疗后TSH水平显著高于治疗前(P<0.01),FT3和FT4水平明显低于治疗前(P<0.01);且对照组病人TSH水平明显高于观察组(P<0.01),FT3和FT4水平显著低于观察组(P<0.01)。观察组病人术后总并发症发生率为6.1%,对照组病人术后并发症发生率为31.2%,差异具有统计学意义(P<0.01)。结论:超声引导下经皮微波消融治疗甲状腺良性结节对甲状腺功能的保护要优于传统手术治疗,且术后并发症较少,是可以替代传统手术治疗的有效疗法。

Objective:To investigate the effects of ultrasound-guided percutaneous microwave ablation in the treatment of thyroid benign nodules on the levels of thyroid hormones and safety of patients. Methods:One hundred and seventy-five patients with benign thyroid nodules were divided into the observation and control group.The observation group was treated with ultrasound-guided percutaneous microwave ablation,and the control group was treated with traditional surgery.The levels of thyroid hormone before and after operation and postoperative complications between two groups were compared,and the effects of different treatments on the thyroid function and incidence rate of complications were analyzed. Results:Before treatment,the differences of the age,course of disease,number of nodules,and levels of TSH,FT3 and FT4 between two groups were not statistically significant( P >0.05).After treatment,the level of TSH,and levels of FT3 and FT4 in control group were higher and lower than those before treatment,respectively( P <0.01),and the level of TSH,and levels of FT3 and FT4 in control group were significantly higher and lower than those in observation group,respectively( P <0.01).The total incidence rate of postoperative complications in observation group and control group were 6.1% and 31.2%,respectively,and the difference of which was statistically significant( P <0.01). Conclusions:The effect of ultrasound-guided percutaneous microwave ablation in the treatment of thyroid benign nodules is better than that of traditional surgery,and its postoperative complication is less.It is an effective alternative to traditional surgical treatment.