不同聚桂醇硬化方法治疗甲状腺囊性肿块疗效对比

Ultrasound-guided single injection versus repeated aspiration-injection of lauromacrogol in treating thyroid cystic mass:comparison of curative effect

目的对比超声引导下两种不同聚桂醇硬化方法治疗甲状腺囊性肿块的临床疗效。方法60例患者根据聚桂醇一次注入(n=34)及聚桂醇反复抽吸(n=26)分组,根据治疗后肿块大小改变比较评估疗效、穿刺异常情况及不良反应。结果一次注入组与反复抽吸组的年龄、性别、术前囊肿体积、囊液性质组成、介入操作时间及最终囊肿体积缩小率的组间差异均无明显统计学意义(均P>0.05),但反复抽吸组对甲状腺囊性肿块硬化的总有效率(96.2%)显著高于一次注入组(76.5%),且其差异有统计学意义(P=0.019)。反复抽吸组抽出的囊液量和术后随访囊肿体积较一次注入组显著增加(P=0.025和0.013),但其针尖脱出的穿刺异常情况及不良反应发生率要显著高于一次注入组(P=0.018)。结论超声引导下介入联合聚桂醇反复抽吸硬化是治疗甲状腺囊性肿块的微创、安全、疗效确切的手段。

Objective To compare the clinical effect of two different ultrasound-guided injection methods of lauromacrogol(used as a sclerotherapy)in treating thyroid cystic mass.Methods A total of 60 patients with thyroid cystic mass were enrolled in this study.Ultrasound-guided single injection of lauromacrogol was adopted in 34 patients(single injection group),and repeated aspiration-injection of lauromacrogol was employed in 26 patients(repeated aspiration-injection group).Postoperative changes in mass size,abnormal puncturing events and adverse reactions were compared between the two groups.Results No statistically significant differences in age,gender,preoperative volume of cystic mass,contents of cystic fluid,time spent for interventional manipulation and reduction rate of cyst volume existed between the two groups(P>0.05 in all).The total effective rate of thyroid cystic mass sclerosis in the repeated aspiration-injection group was 96.2%,which was remarkably higher than 76.5%in the single injection group,the difference was statistically significant(P=0.019).Both the amount of extracted cystic fluid and the cyst volume during follow-up period in the repeated aspiration-injection group were larger than those in the single injection group(P=0.025 and P=0.013,respectively).The incidences of abnormal puncturing events such as needle-tip dropping off right site and adverse reactions in the repeated aspiration-injection group were higher than those in the single injection group(P=0.018).Conclusion For the treatment of thyroid cystic mass,ultrasound-guided sclerotherapy by using repeated aspiration-injection of lauromacrogol is minimally-invasive and safe with reliable curative effect.