超声引导微波消融治疗乳头状甲状腺微小癌的临床效果观察

Observation of Clinical Efficacy of Ultrasound-guided Microwave Ablation in the Treatment of Papillary Thyroid Microcarcinoma

目的:观察超声引导微波消融治疗乳头状甲状腺微小癌的临床效果。方法:选取2017年3月-2018年12月于本院治疗的80例乳头状甲状腺微小癌患者作为研究对象,根据手术治疗方法不同将其分成对照组和观察组,每组40例。对照组采用传统外科手术治疗,观察组采用超声引导下微波消融术治疗。比较两组手术相关指标、手术前后甲状腺功能、甲状腺结节体积及术后并发症发生情况。结果:观察组手术时间、术中出血量及住院时间均少于对照组(P<0.05)。术后,观察组游离三碘甲状腺原氨酸(FT_(3))与游离甲状腺素(FT_(4))水平均高于对照组,促甲状腺激素(TSH)水平低于对照组(P<0.05)。术后,对照组FT_(3)与FT_(4)水平均低于术前,TSH水平高于术前(P<0.05),而观察组手术前后FT_(3)、FT_(4)及TSH水平比较,差异均无统计学意义(P>0.05)。观察组并发症发生率为7.5%,低于对照组的37.5%(P<0.05);观察组术后1、3、6个月的甲状腺结节体积逐渐缩小(P<0.05)。结论:超声引导微波消融治疗乳头状甲状腺微小癌的临床效果值得肯定,其最大限度地保留了甲状腺功能,降低并发症发生,具有较高的临床价值。

Objective:To observe the clinical efficacy of ultrasound-guided microwave ablation in the treatment of papillary thyroid microcarcinoma.Method:A total of 80 patients with papillary thyroid microcarcinoma treated in our hospital from March 2017 to December 2018 were selected as the research objects.They were divided into control group and observation group according to different surgical treatment methods,with 40 cases in each group.The control group was treated with traditional surgery,and the observation group was treated with ultrasound-guided microwave ablation.Surgicity-related indexes,thyroid function,thyroid nodule volume before and after surgery and postoperative complications were compared between the two groups.Result:The operative time,intraoperative blood loss and hospitalization time of the observation group were less than those of the control group(P<0.05).After surgery,the levels of free triiodothyrogenine(FT_(3))and free thyroxine(FT_(4))in the observation group were higher than those in control group,while the levels of thyroid stimulating hormone(TSH)in the observation group was lower than that in the control group(P<0.05).After surgery,FT_(3) and FT_(4) level in the control group were lower than those before surgery,and TSH level was higher than that before surgery(P<0.05),while there were no statistical significance in FT_(3),FT_(4) and TSH levels in the observation group before and after surgery(P>0.05).The complication rate of the observation group was 7.5%,which was lower than 37.5%of the control group(P<0.05).The volume of thyroid nodule in the observation group at 1,3 and 6 months after surgery decreased gradually(P<0.05).Conclusion:The clinical efficacy of ultrasound-guided microwave ablation in the treatment of papillary thyroid microcarcinoma is worthy of affirmation,it retains thyroid function to the maximum extent,reduces complications,and has high clinical value.