超声引导下微波消融术治疗甲状腺良性肿瘤的临床分析

Ultrasound-guided microwave ablation in the treatment of thyroid benign tumors

目的分析传统手术和超声引导下微波消融术(MWA)治疗甲状腺良性肿瘤的临床效果,并对并发症的发生情况及短期疗效进行探讨。方法回顾性分析徐州医科大学附属淮安医院2017年1—12月收治的63例甲状腺良性肿瘤患者的临床资料,观察组(30例)接受微波消融治疗,对照组(33例)接受传统手术治疗。分析2组的治疗效果,观察2组伤口的美容评分、术后24 h疼痛评分(VAS)、住院费用、并发症发生率、术中出血量、住院时间、手术时间、甲状腺功能指标、肿块体积变化、术后第1天2组炎症因子变化情况及术后第1天日常生活能力评定(BI)情况。结果观察组术后24 h VAS评分、住院时间、术中出血量、住院费用、手术时间、术后并发症发生率、对甲状腺功能影响、对机体的创伤、对术后生活活动能力的影响等均低于对照组,观察组伤口美容评分高于对照组,差异有统计学意义(P<0.05);并且观察组术后肿块缩小明显,术后时间越长,缩小率越高。结论微波消融术治疗甲状腺良性肿瘤是一种损伤小、并发症少、美容效果明显的良好的手术方式。

Objective To compare the clinical effect between traditional operation and ultrasound-guided microwave ablation(MWA)in the treatment of thyroid benign tumor,and to explore the complications and short-term effect.Methods A retrospective analysis of 63 patients with thyroid benign tumor who were admitted to the Affiliated Huai’an Hospital of Xuzhou Medical University from January 2017 to December 2017 was conducted,and 30 patients in the observation group were treated by ultrasound-guided MWA,33 patients in the control group received traditional surgical treatment.The therapeutic effects of the two groups were analyzed,and the wound cosmesis score,24-hour postoperative pain score(VAS),hospitalization expenses,postoperative complication rate,intraoperative bleeding volume,length of hospital stay,operation time,changes in thyroid function index,changes in tumor volume,changes in inflammatory factors in the first day after operation,and assessment of daily living ability measured by the Barthel Index(BI)on the first day after operation were observed.Results Compared with the control group,patients in the observation group reported lower 24-hour postoperative VAS score,with shorter length of hospital stay,lower intraoperative hemorrhage volume,lower hospitalization expenses,shorter operation time,lower postoperative complication rate,as well as less influence on thyroid function,body trauma and life activity(P<0.05).The wound cosmesis score of the observation group was higher than that of the control group(P<0.05).In the observation group,the reduction of tumor volume was better compared to the control group,and the longer the postoperative time,the higher the reduction rate(P<0.05).Conclusions Ultrasound-guided MWA for thyroid benign tumor is a good way of operation with little damage,fewer complications and better cosmetic effect.