经皮微波消融术治疗甲状腺良性结节的疗效及影响因素

The effect and influencing factors of percutaneous microwave ablation for the treatment of benign thyroid nodules

目的探讨经皮微波消融术治疗甲状腺良性结节的疗效及影响因素。方法回顾性分析2017年4月至2019年4月在广州中医药大学第二附属医院行超声引导下经皮微波消融治疗甲状腺良性结节的临床资料。术后第1、3、6个月行常规超声检查,计算结节的体积缩小率,将结节按照性别、年龄、结节血供、结节大小、结节性质、是否有桥本氏甲状腺炎背景进行分组,并对影响微波消融的相关因素进行分析。结果甲状腺良性结节患者68例(106个结节)均采用经皮微波消融术治疗。术后第1、3、6个月结节体积缩小率(VRR)分别为(39.7±6.1)%、(56.2±5.9)%、(70.3±5.4)%,差异均有统计学意义(P<0.05),消融灶体积随时间逐渐缩小。不同结节大小、结节性质、有无桥本氏甲状腺炎背景者术后第1、3、6个月的VRR比较,差异均有统计学意义(P<0.05)。而不同性别、年龄、结节血供术后第1、3、6个月的结节缩小率比较,差异无统计学意义(P>0.05)。Pearson相关分析发现,VRR与单位体积消融时间呈负相关(P<0.05),logistic回归分析发现结节性质及单位体积消融时间进入回归方程。结论结节大小、结节性质、桥本氏甲状腺炎背景以及单位体积消融时间会影响术后体积缩小率。

Objective To investigate the effect and influencing factors of microwave ablation(MVA)in the treatment of benign thyroid nodules.Methods The clinical data of ultrasound-guided microwave ablation for thyroid benign nodules in the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from April 2017 to April 2019 were retrospectively analyzed.At 1,3 and 6 months after operation,conventional ultrasound examination was performed to calculate the volume reduction rate of the nodules.The nodules were divided into groups according to gender,age,nodule blood supply,nodule size,nodule nature and Hashimoto′s thyroiditis background,and the related factors influencing microwave ablation were analyzed.Results 68 patients(106 nodules)with benign thyroid nodules were treated with microwave ablation.The volume of benign thyroid nodules after the MWA treatment was significantly reduced after 1,3,6 months,and their nodule volume reduction ratio(VRR)were(39.7±6.1)%(1 months),(56.2±5.9)%(3 months),(70.3±5.4)%(6 months),respectively.There were significant differences in the volume reduction ratio of nodules at 1,3 and 6 months after operation among different nodule size,nodule nature and Hashimoto′s thyroiditis background,with statistically significant difference(P<0.05).However,there was no significant difference in the reduction ratio of nodules in different gender,age and nodule blood supply at 1,3 and 6 months after operation(P>0.05).Pearson correlation analysis showed that VRR was negatively correlated with ablation time per unit volume,with statistically significant difference(P<0.05).Logistic regression analysis indicated that only nodule nature and ablation time per unit volume entered the regression equation.Conclusions The size and nature of the nodules,Hashimoto′s thyroiditis background and ablation time per unit volume will affect the postoperative volume reduction rate.